老年人皮质下动脉硬化性脑病的病理学基础和CT、MRI对照研究  

The Pathological Basis and CT, MRI Analysis of Subcortical Arteriosclerotic Encephalopathy in the Aged

作　　者：刘军[1] 李正仪[1] 刘建[1] 范光忠[1] 

机构地区：[1]西安医科大学第一附属医院放射科,西安医科大学第一附属医院神经科,中国人民解放军第三医院放射科,中国人民解放军第三二三医院

出　　处：《临床放射学杂志》1994年第1期7-11,共5页Journal of Clinical Radiology

摘　　要：本文就２６例皮质下动脉硬化性脑病患者的ＣＴ、ＭＲＩ检查结合病理学基础进行了分析。ＭＲＩ检查，当ＴＲ＝２０００ｍｓｅｃ，ＴＥ＝３０、６０ｍｓｅｃ时，皮质动脉硬化性脑病损害均为明显的高信号，Ｔ１加权像为低信号。ＣＴ像为低密度改变。Ｔ２加权像上半卵圆中心的白质表现为不均匀弥漫的高信号区，可累及基底节、丘脑、脑干及小脑的白质，并有不同程度的侧脑室扩大、脑室边缘呈斑片状改变可有脑萎缩。病理学特征是弥漫不完全的皮质下梗塞，在侧脑室旁及半卵圆中心的白质内髓鞘肿胀或脱失，皮质下腔隙或软化，在髓动脉内有狭窄性动脉粥样硬化。临床主要包括痴呆、眼底动脉硬化和高血压。本文将ＭＲＩ与ＣＴ检查进行了比较，认为在确定皮质下白质内小的损害及确定脑干和小脑白质损害方面ＭＲＩ优于ＣＴ。Twenty six cases of subcortical arteriosclerotic encephalopathy(SAE) were evaluated by MRI and CT. MRI was done. at a pulse-repetition interval of 2000msec and the echo delay time of 30,60msec; SAE lesions were markedly higher signal compared with brain. The T1 weighted images were lower signal and CT images were decreased density in SAE lesions. A diffuse area of nonhomogeneous higher signals was observed in the deep white matter of cerebral hemispheres, involving basal ganglia,thalamus, brain trunk, and cerebellum white matter, together with varying degrees of dilatation of the lateral ventricles,ragged margins,and atrophy of brain on T2 weighted images. Its pathological features were a diffuse area of incomplete subcortical infarction containing multiple small infarcts as well as cyst formation, myelin sheaths swollen or loss in the white matter of lateral periventric and centrum semiovale, subcortical lacunes or malacia, marked stenotic atherosclerotic changes in the medullary arteries, The clinical features included dementia, patchy mental lapses, eyeground arteriosclerosis and hypertension. MRI and CT features of the SAE were compared. The authors felt that MRI was more accurate than CT in determining brain trunk, cerebellum white matter lesion and deep white matter small lesion of centrum semiovale of the subcortical arteriosclerotic encephalopathy.

关 键 词：皮质下 动脉硬化 脑病 CT NMR 成像 

分 类 号：R816.1[医药卫生—放射医学]