MR扩散加权成像对Creutzfeldt-Jakob病的诊断意义  

Value of diffusion-weighted MR imaging in the diagnosis of Creutzfeldt-Jakob disease

作　　者：徐全刚[1] 吴卫平[1] 黄德晖[1] 张家堂[1] 郎森阳[1] 蒲传强[1] 

机构地区：[1]解放军总医院神经内科,北京100853

出　　处：《中华放射学杂志》2005年第6期624-626,共3页Chinese Journal of Radiology

摘　　要：目的评价MR扩散加权像(DWI)对CreutzfeldtJakob病(CJD)的诊断价值。方法8例散发性CJD(4例确诊,3例临床很可能,1例临床可能),比较其常规MRI及DWI检查结果。结果T1WI及T2WI除4例显示脑萎缩外,未见异常信号;而8例DWI均异常,其中2例为单纯大脑皮层高信号改变,6例为大脑皮层合并尾状核、壳核高信号改变,5例呈对称性,3例呈非对称性;1例液体衰减反转恢复(FLAIR)序列成像显示大脑皮层呈稍高信号,但不如DWI明显。结论DWI显示的大脑皮层和(或)纹状体的高信号改变是CJD的特征之一,其诊断价值明显优于常规MRI,是早期诊断CJD的重要方法。Objective To assess the diagnosis value of diffusion- weighted imaging (DWI) in Creutzfeldt-Jakob disease (CJD).Methods 8 cases of sporadic CJD who underwent MRI were reported. 4 cases were definite,3 cases were probable and 1 case was possible. The sensitivity of DWI and conventional MRI were compared. Results T_1WI and T_2WI revealed no abnormal signals except nonspecific diffuse brain atrophy in 4 cases, whereas DWI detected hyperintense abnormalities in all cases. 2 cases showed linear lesions only in the cerebral cortex, and 6 cases showed lesions in both the cerebral cortex and the striatum. The lesions were symmetric in 5 cases, but were asymmetric in the other 3 cases. Although fluid-attenuated inversion recovery (FLAIR) imaging also showed cortical hyperintensity in 1 case, the high signal changes were more evident and extensive on DWI. Conclusions The hyperintense changes in the cerebral cortices and/or striata on DWI are considered characteristic of CJD. DWI is more sensitive than conventional MRI in depicting lesions of CJD and may be an essential tool for the early diagnosis of this disease.

关 键 词：CREUTZFELDT-JAKOB病 MR扩散加权成像 诊断意义 液体衰减反转恢复 常规MRI 信号改变 大脑皮层 诊断价值 DWI 检查结果 T1WI 异常信号 非对称性 序列成像 早期诊断 CJD 加权像 散发性 脑萎缩 显示 尾状核 高信号 纹状体 

分 类 号：R445.2[医药卫生—影像医学与核医学]