原发性中枢神经系统血管炎的临床及影像学分析  

Clinical Analysis and MRI Features of Primary Angiitis of the Central Nervous System

作　　者：巫顺秀[1] 郑璇[1] 庄伟端[1] 杜登青[1] 

机构地区：[1]汕头大学医学院第一附属医院神经内科,515041

出　　处：《中国临床实用医学》2009年第12期84-86,共3页China Clinical Practical Medicine

摘　　要：目的探讨原发性中枢神经系统血管炎的临床和影像学表现，以明确诊断要点。方法临床或病理证实的中枢神经系统血管炎8例，其中男性3例，女性5例。年龄从19～73不等，平均年龄40．3岁。全部行MRI检查，其中增强4例；8例行MRA检查，分析所有病例的临床资料和MR片。结果8例PACNS中，8例位于幕上，以额叶及顶叶多见，其中3例为双侧多发；幕下4例位于脑干及脊髓。影像学上，多数病灶边界模糊，与相应血管分布区一致，累及灰质和自质，但以白质为主，可有水肿，增强后有不同程度增强，呈斑片样或脑回样，甚至呈结节样，类似肿瘤。血管成像可以发现血管炎的征象。结论原发性中枢神经系统血管炎的临床和影像学表现多样，MRI具有一定价值，MRA及DSA对诊断帮助较大，确诊需要活检病理证实。Objective To study the clinical and imaging feature of primary angiitis of the central nervous system（PACNS） , in order to find the key point of diagnosis. Materials and Methods Pathological or clinical proved PACNS 9 cases , 3 men and 5 women , ranging from 19 ~ 73 years old with average 40.2 years old. All were examined with MRI and 4 by enhanced scan; 8 with MRA and 2 with DSA. Clinical information and all films （ MRI and DSA） were analyzed. Results In 8 cases of PACNS , 1 cases were proved by operation or biopsy , and 7 cases were proved by clinical follow - up. 8 cases were located supratentorial , most were in frontal lobe , 3 cases were multiple focuses in both sides ; 4 cases were located infratentorial and brain sten and spinal . On imaging , most focuses were with blurry margin , and the regions were accordant with that of the blood vessel. The lesions involved gray matter and white matter , but mostly in white matter , edema could be seen in some cases. Different grade of enhancement could be seen , the enhancement may be patchy or convolutional , even nodulous witch was resemble with tumor. The sign of angiitis could be seen in angiography. Conclusion The clinical and imaging features of PACNS are various , CT and MRI are valuable , MRA and DSA are helpful in diagnosis , but the diagnosis must given by pathological examination.

关 键 词：原发性中枢神经系统血管炎 临床 磁共振成像 

分 类 号：R741[医药卫生—神经病学与精神病学] R563.1[医药卫生—临床医学]