多系统萎缩临床亚型诊断的研究  

Clinical subtype diagnosis of multiple system atrophy.

作　　者：冯向营[1] 赵莉[2] 王展[3] 王怡[1] 

机构地区：[1]大连大学附属新华医院神经内科,辽宁大连116021 [2]大连医科大学附属第一医院神经内科 [3]首都医科大学附属北京天坛医院神经内科

出　　处：《中国冶金工业医学杂志》2008年第3期260-262,共3页Chinese Medical Journal of Metallurgical industry

摘　　要：目的:探讨多系统萎缩(MSA)的临床表现与MRI特征及其临床亚型诊断的价值。方法:回顾性总结30例MSA患者的临床及MRI资料。结果:橄榄脑桥小脑萎缩(OPCA),以小脑体征为主要表现;MRI检查为脑桥和小脑部萎缩,第四脑室扩大;T2W1出现脑桥小脑对称性高信号及脑桥十字征。纹状体黑质变性(SND),以锥体外系症状明显,MRI改变多位于基底核团,呈现壳核萎缩,T2W1显示壳核外侧缘缝隙样高信号。Shy-Drager综合征(SDS),以自主神经症状明显,出现早而且重;MRI未见特异性改变。结论:MSA诊断主要依据临床症状及神经系统异常体征和MRI特征,临床亚型诊断使MSA诊断细化,体现了系统病征特点,具有应用价值。Objective：To explore the clinical situation, MRI characters and the clinical subtype diagnosis of multiple system atrophy （MSA）. Methods.. The clinical and MRI data of 30 cases of MSA were retrospectively analyzed. Results： Olivopontocerebellar atrophy： the main situations were the cerebellum symptoms; bridge of varolius and cerebellum atrophy were detected in the MRI imaging complied with the 4th ventriculomegaly;symmetry signal and crux sign were seen in T2Wl. Striatonigral degeneration： the main situations were extrapyramidal symptoms. Putamen atrophy was found in MRI imaging. Crack sign of the Putamen was detected in T2Wl. Shy-drager syndrome： the main situations were the severe autonomic nerve symptoms were the early clinical manifestation. No specific imaging changes were detected in MRI. Conclusions：The diagnosis of MSA based mainly on clinical situation,abnormal sign of nervous system and MRI characters. The clinical subtype diagnosis,what refined the MSA diagnosis,reflected the features of system disease,have clinical utility.

关 键 词：多系统萎缩 诊断 MRI 

分 类 号：R741[医药卫生—神经病学与精神病学]