海洛因脑病MRI与病理对照分析  

Comparative Study of MR Imaging and Histopathology in Heroin Associated Encephalophathy

作　　者：张雪林[1] 邱士军[1] 连海英[1] 马湘乔[1] 

机构地区：[1]广州南方医科大学南方医院影像中心,510515

出　　处：《临床放射学杂志》2007年第9期851-853,共3页Journal of Clinical Radiology

基　　金：国家自然科学基金面上项目(编号:3027042;30370435)

摘　　要：目的探讨海洛因脑病(HE)的MRI特点及其病理基础。资料与方法34例中,根据流行病学、临床表现、MRI、实验室检查及其中10例病理检查结果,排除其他疾病而诊断HE。行MRT1WI、T2WI、液体衰减反转恢复序列(FLAIR)检查。4例死亡患者中2例行尸解,8例行脑立体定向活检。MRI与病理对照分析。结果34例HE病例T1WI呈低信号,T2WI呈高信号。病灶同时累及幕上半球、脑干及小脑占85.3%,三者分别单独受累均<10%。病灶以累及脑白质为主。脑内两侧同时受累占91.2%。MRI示幕上半球"八字征"、脑干"中空征"及小脑"蝶翼征"对诊断HE有一定意义。MRI信号改变,主要与HE的脑白质脱髓鞘及大量空泡形成,这些空泡构成海绵状结构,内含液体增多有关。结论MRI对HE能准确地定位、定量诊断,并有一定特征MRI表现。MRI显示HE与病理之间有很好的相关性。Objective To discuss the features of MR imaging and histopathologic basis of heroin associated encephalopathy（HE）. Materials and Methods 34 cases with HE were diagnosed with epidemiology evidence, clinical situation, MRI and laboratory examination results. 10 cases had histopathologic results. All the cases were scanned with T1WI, T2WI,FLAIR by 1.5T MRI scanner. 4 cases died, 2 of which were performed autopsy. 8 cases were taken cerebral stereotaxis biopsy and compared the result with MR images. Results All the 34 cases had hypointensity signals in TI WI and hyperintensity signals in T2WI, 85.3% of which had extensive involvement with hemispheres beyond cerebellar tentorium, brain steam to cerebellum. However, each group involving just one of these parts was less than 10%. Most lesions mainly invaded the white matter. 91.2% of 34 cases showed involvement in both sides of brain. There were some specific MRI features including the ＂chinese character, eight＂ sign in hemispheres beyond the cerebellar tentorium,＂ medium empty＂ sign in brain steam and ＂butterfly wing＂ sign in cerebellum. The abnormal signals were mainly caused by demyelination and vacuoles formation in white matter, these vacuoles made white matter as sponge - like and contained a lot of fluid. Conclusion MRI can make diagnosis for HE, it provides information about the involvement, position and aggravation degree. There are some MRI features in HE. MRI features have well relationships with histopathologic results.

关 键 词：海洛因脑病 磁共振成像 脑白质病 

分 类 号：R445.2[医药卫生—影像医学与核医学]