Relationship between MRI manifestations and clinical features of autoimmune encephalitis and its evolution
YIN Quhua
AN Ran
LING Jie
WEI Xuan
Abstract：Objective To extract the cranial MRI manifestations and clinical features of autoimmune encephalitis(AE),to analyze the relationship between MRI manifestations and various clinical features,and to explore the application value of MRI in the initial diagnosis and follow-up of AE.Methods A retrospective analysis was conducted on the clinical and brain MRI imag-ing data of 27 cases diagnosed with AE(anti-NMDA receptor encephalitis and anti-LGI1 encephalitis)and the brain MRI fea-tures were analyzed.Binary logistic regression was used to evaluate the correlation between imaging findings and clinical charac-teristics.Regular follow-up was conducted to assess the clinical outcomes of the disease,including recurrence and Modified Rankin Scale.The evolution of signals from the onset of the disease to the appearance of different conditions on MRI was recorded and analyzed.Results 1)Clinical characteristics:13 male cases(48.1%)and 14 female cases(51.9%)were included;the age ranged from 14 to 80 years,with a median age of 61 years.Lipid metabolism abnormalities were present in 16 cases(59.3%).During the follow-up period of 1 to 72 months,21 cases(77.8%)had a good prognosis,6 cases(22.2%)had a poor prognosis,and 4 cases(14.8%)experienced recurrence.2)MRI findings:Brain MRI was normal in 9 cases(33.3%),abnor-mal or atypical changes were seen in 18 cases(66.7%),including hippocampal abnormalities in 14 cases(51.9%),temporal lobe abnormalities in 9 cases(33.3%),and white matter lesions in 6 cases(22.2%).Binary logistic regression analysis revealed no correlation between brain MRI findings and clinical features.Two patients with normal initial MRI at onset developed new ab-normal signals during follow-up after immunotherapy.Among the 18 patients with MRI abnormalities,11 showed improvement,4 worsened,and 3 had no significant changes in MRI findings;4 patients experienced relapse after effective treatment.The MRI findings of initial diagnosis and recurrent AE were similar.Conclusion The incidence of abnormal lipid metabolism in young AE patients and patients with abnormal MRI findings are relatively high;and cranial MRI examination can be used for the diagnosis and differential diagnosis of AE,evaluation of therapeutic effects,and long-term follow-up.
Keywords：Autoimmune encephalitisMagnetic resonance imagingFollow-up studiesApplication Value
Publication Date：2025-03-30
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 1-5,10 )