Differential diagnosis of temporal lobe lesions with hyperintense signal on T2-weighted and FLAIR sequences: pictorial essay

Abstract Various neuropathologies produce hyperintense signals on T2-weighted or fluid-attenuated inversion recovery sequences of the temporal lobes. Recognition of the distribution pattern and associated findings may narrow the spectrum of differential diagnoses or suggest a specific disease. This pictorial essay aims to illustrate the relatively common diseases that affect the temporal lobe, such as herpes simplex encephalitis, neurosyphilis, limbic encephalitis, postictal edema, neoplasia, and multiple sclerosis, as well as those that are less common, such as myotonic dystrophy type 1, CADASIL, and CARASIL, together with the particularities of each entity.

摘要 多种神经病理异常可在颞叶的T2加权成像（T2-weighted）序列与液体衰减反转恢复（fluid-attenuated inversion recovery, FLAIR）序列上呈现高信号。识别病变的分布模式及伴随影像学征象，可缩小鉴别诊断谱，或提示特异性疾病。本影像学图解综述旨在阐述累及颞叶的各类疾病：既包括单纯疱疹性脑炎、神经梅毒、边缘性脑炎、发作后水肿、肿瘤性病变及多发性硬化等常见疾病，也涵盖肌强直性营养不良1型、大脑常染色体显性遗传性动脉病伴皮质下梗死和白质脑病（CADASIL）、大脑常染色体隐性遗传性动脉病伴皮质下梗死和白质脑病（CARASIL）等少见病变，并逐一介绍各疾病的特征性表现。