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目的：回顾分析单纯疱疹病毒性（ＨＳＶ）脑炎的ＭＲ成像表现，为临床早期诊断和治疗提供依据。材料和方法：１０例（男４例，女６例；平均年龄３９．５岁）经脑脊液ＰＣＲ证实的ＨＳＶ脑炎患者，采用高磁场（１．０Ｔ）磁共振扫描仪，以自旋回波序列行横断／冠状面Ｔ１加权、质子加权、Ｔ２加权成像和注造影剂后Ｔ１加权成像。结果：１０例中，８例ＭＲ像存在异常信号（广泛、多发、双侧者６例，局灶改变２例）。Ｔ１加权像呈均质低信号５例，该５例在Ｔ２加权像呈均质高信号，提示病理上病灶区坏死，伴周围水肿；３例Ｔ１加权像呈片状低信号内伴脑回状高信号，Ｔ２加权像呈不均质信号，病理上代表出血；增强后Ｔ１加权像呈脑回状强化３例，１例呈结节状改变。结论：以颞叶、岛叶、额底分布为主（尤其为扣带回受累）的多发病灶、伴脑回状出血和强化是ＨＳＶ脑炎的特征性ＭＲ成像表现。不典型表现须与脑瘤、脑梗塞和其它类型病毒性脑炎鉴别诊断。
Objective: To retrospectively analyze the manifestations of MR imaging of herpes simplex virus (HSV) encephalitis and provide the basis for early clinical diagnosis and treatment. MATERIALS AND METHODS: Ten patients (4 males and 6 females; mean age 39.5 years) with HSV encephalitis confirmed by cerebrospinal fluid PCR were analyzed by high magnetic field (1.0T) magnetic resonance scanner with spin echo sequence T1 transection / coronal T1 weighted, proton weighted, T2 weighted imaging and contrast-enhanced T1-weighted imaging. Results: In 10 cases, there were abnormal signals in 8 MR images (extensive, multiple, bilateral in 6 cases and focal changes in 2 cases). T1 weighted images were homogeneous low signal in 5 cases, the 5 cases of T2 weighted images were homogeneous high signal, suggesting pathological necrosis of the lesion area, with peripheral edema; 3 cases of T1 weighted image flaky low signal with brain back High signal, T2 weighted image showed a heterogeneous signal, the pathology represents bleeding; enhanced T1 weighted image was brain enhanced in 3 cases, 1 case was nodular changes. CONCLUSIONS: Multiple lesions with temporal lobe, insula, and forehead distribution (especially cingulate gyrus involvement), with cerebral hemorrhage and enhancement, are characteristic features of MR imaging of HSV encephalitis. Atypical manifestations must be with brain tumors, cerebral infarction and other types of viral encephalitis differential diagnosis.