多系统萎缩磁共振成像特征的研究  

MRI Characteristics of Multiple System Atrophy

作　　者：吴武林[1] 王小宜[1] 廖伟华[1] 熊曾[1] 刘凡[1] 陈长青[1] 

机构地区：[1]中南大学湘雅医院放射科,湖南长沙410008

出　　处：《实用放射学杂志》2008年第6期724-727,共4页Journal of Practical Radiology

摘　　要：目的探讨多系统萎缩(MSA)的磁共振成像特征以及各型之间的差别。方法回顾性分析经临床诊断为MSA的32例病人常规磁共振成像资料,其中橄榄桥脑小脑萎缩(OPCA)17例,纹状体黑质变性(SND)8例,Shy-Drager综合征(SDS)7例。结果OPCA组主要有十字征、小脑中脚高信号、小脑萎缩、小脑中脚萎缩、延髓萎缩、桥脑萎缩及四脑室扩大等7项MR表现。SND组主要有壳核边缘裂隙状高信号、壳核高信号及壳核萎缩等3项MR表现。而SDS组缺乏特征性MR表现。OPCA组与SND组比较,十字征、小脑中脚高信号、小脑萎缩、小脑中脚萎缩、延髓萎缩、桥脑萎缩、四脑室扩大、壳核边缘裂隙状高信号和壳核萎缩等9项MR表现差别有统计学意义(P(0.05)。OPCA组与SDS组比较,十字征、小脑萎缩、小脑中脚萎缩、延髓萎缩、桥脑萎缩和四脑室扩大等6项MR表现差别有统计学意义(P(0.05)。而SND组与SDS组比较差别有统计学意义的MR表现只有壳核萎缩和壳核边缘裂隙状高信号2项。结论常规磁共振成像有助于MSA的诊断及各型的鉴别诊断。Objective To explore routine magnetic resonance imaging characteristics of multiple system atrophy（ MSA ） and differences between its different types. Methods MRI features of 32 patients with MSA were retrospectively analyzed, including olivopontocerehellar atrophy （ OPCA ） in 17, striatonigral degeneration （SND ） in 8 and Shy - Drager syndrome （ SDS） in 7. Results The main MRI findings of OPCA included cross sign,hyperintensity of middle cerehellar peduncles, cerehellar atrophy, atrophy of middle cerehellar peduncles, medulla ohlongata atrophy, pontine atrophy and the dilatation of fourth ventricle. The main MRI findings of SND were hyperintense rim of putamen, putaminal hyperintensity and putaminal atrophy. But the group of SDS was lack of characteristic MRI findings. In comparing MRI findings （ cross sign ,hyperintensity of middle cerehellar peduncles, cerehellar atrophy, atrophy of middle cerehellar peduncles, medulla ohlongata atrophy, pontine atrophy,the dilatation of fourth ventricle, hyperintense rim of putamen and putaminal atrophy} between the OPCA group and the SND group, the differences were found to he statistically significant （P 〈 0.05 ）. In comparing MRI findings including cross sign , cerehellar atrophy, atrophy of the middle cerehellar peduncles, medulla ohlongata atrophy, pontine atrophy and the dilatation of fourth ventricle between OPCA group and the SDS group, the differences were found to he statistically significant （P 〈 0.05）. While in comparing SND group and SDS group, statistical significance was found only in putaminal atrophy and hyperintense rim of putamen. Conclusion The routine MRI is helpful in the diagnosis and the differential diagnosis of MSA.

关 键 词：脑 多系统萎缩 橄榄桥脑小脑萎缩 纹状体黑质变性 磁共振成像 

分 类 号：R742[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]