目的探讨视频脑电图和MRI联合 应用在成人病毒性脑炎的早期诊断价值。 方法 回顾性分析我院2015年1月-2018年1 月收治128例病毒性脑炎患者临床资料， 分析其MRI及视频脑电图检测结果。结果 病毒性脑炎患者视频脑电图重度异常率 显著高于MRI(P<0.05)，正常率显著低于 MRI(P<0.05)，轻中度异常率与MRI比较差 异无统计学意义(P>0.05)。128例患者行 MRI检测发现，病变位置多累及颞叶内侧 及额叶，少部分累及脑岛。单一受累患 者84例，其中额叶15例(17.86%)、顶叶 10例(7.82%)、颞叶15例(17.86%)、岛叶 21例(16.41%)、基底节13例(15.48%)、 脑桥7例(5.47%)、小脑3例(3.57%)。31 例(24.22%)二部位累及，13例(10.16%) 三部位及以上累及。病灶多为双侧、多 发，皮质、白质均可受累，其中皮质最常 见。信号多表现为T1WI低信号，T2WI高信 号，FLAIR序列对病变的显示优于T1WI、 T2WI，其中14例(10.93%)T2加权成像为 正常信号，但FLAIR为高信号。出血时， T1WI、T2WI均表现为高信号，增强扫描结 果差异很大，主要包括无明显强化、线样 强化、脑回样强化及少部分脑膜强化。结 论 视频脑电图和MRI联合应用在成人病毒 性脑炎的诊断价值较高，联合检查更能明 确成人病毒性脑炎的病变程度、累及范 围，提高检出率。

Objective To investigate the value of combined detection of video electroencephalography（VEEG） and MRI in early diagnosis of adult viral encephalitis (VE). Methods Clinical data of 128 patients with VE in our hospital from January 2015 to January 2018 were analyzed retrospectively, and the results of MRI and VEEG were also analyzed. Results The VEEG had higher severe abnormal rate and lower normal rate than those of the MRI (P<0.05), while no difference was found in the mild to moderate abnormal rate (P>0.05). The MRI results showed that the lesions of 128 patients were mostly involved in the medial and frontal lobes of the temporal lobe, and a few were involved in the insula. Single affected organs included 15 cases (17.86%) of frontal lobe, 10 cases (7.82%) of parietal lobe, 15 cases (17.86%) of temporal lobe, 21 cases (16.41%) of insular lobe, 13 cases (15.48%) of basal ganglia lobe, 7 cases (5.47%) of brain stem, and 3 cases (3.57%) of cerebellum. Double affected organs included 31 cases (24.22%), and 13 cases (10.16%) had more than three lesions involved. Most of the lesions were bilateral, multiple, cortica,, and both cortex and white matter could be involved, which was commonly seen in the cortex matter. The signals showed low signal on T1WI and high signal on T2WI. The lesions were better displayed in FLAIR sequence than T1WI and T2WI imaging, of which 14 (10.93%) had normal signals in T2WI while presented as high signal by FLAIR. Both T1WI and T2WI had high signals during hemorrhage, and enhanced scans varied greatly, including no significant enhancement, line-like enhancement, brain-like enhancement, and minor meningeal enhancement. Conclusion Combination of VEEG and MRI has a high detection value for adult VE, which can clarify the disease severity and lesions involvement with higher detection rate.