18F-FDG PET/CT imaging features of autoimmune encephalitis with anti-LGI1 antibody
Objective To study the imaging features of 18F-deoxyglucose(FDG)positron emission tomography(PET)/computed tomography(CT)in the head of patients with anti-leucine-rich glioma-inactivated 1(LGI1)antibody autoimmune encephalitis(AE),and to evaluate the value of PET/CT in the early diagnosis of anti-LGI1 antibody AE.Methods The data of 43 patients with LGI1-AE diagnosed in the Department of Neurology,Beijing Tiantan Hospital,Capital Medical University from October 2014 to November 2020 were retrospectively analyzed,including 24 patients in acute phase(56％),19 patients in chronic phase(44％),and AE patients whose anti-LGI1 autoimmune antibodies were positive in cerebrospinal fluid or/and serum.The imaging and clinical features of 18F-FDG PET/CT were analyzed.Results 18F-FDG PET imaging showed that 40 LGI1-AE patients(93％)had obvious metabolic abnormalities,while only 26 patients(60％)had abnormal magnetic resonance imaging(MRI)signals(P＜0.05).The abnormal metabolism of 18F-FDG PET is reversible after treatment,and the metabolism of 18F-FDG PET in most patients is almost normal after discharge.The hypermetabolic regions of patients with LGI1-AE are located in the basal ganglia(BG)and medial temporal lobe(MTL).Hypermetabolism in the BG was observed in 33 patients(77％),and hypermetabolism in the MTL was observed in 72％of the patients.A total of 22 patients(51％)showed facial arm dystonia seizures(FBDS),whereas rest showed non-FBDS symptoms(49％).Hypermetabolism in the BG was detected only in 7 patients with FBDS(7/21),while that detected in only 2 patients without FBDS(2/19)(33％vs 10％).Conclusion 18F-FDG PET imaging was more sensitive in the early diagnosis of LGI1-AE.Most of the patients with FBDS showed hypermetabolism isolated in the BG,suggesting the potential involvement of the BG.
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