高原脑水肿的早期影像学表现探讨  

Investigation of pulmonary image of high altitude cerebral edema in early stage

作　　者：李素芝[1] 谭健[2] 刘斌[2] 王宇亮[1] 闫春城[1] 郑必海[1] 郑建保[3] 

机构地区：[1]西藏军区总医院高山病科,拉萨850007 [2]西藏军区总医院医学影像科,拉萨850007 [3]西藏军区总医院干部病房,拉萨850007

出　　处：《西南国防医药》2010年第5期527-529,共3页Medical Journal of National Defending Forces in Southwest China

基　　金：国家科技支撑计划课题(2009BAI85B05)

摘　　要：目的探讨高原脑水肿(high altitude cerebral edema,HACE)早期的影像学表现,为HACE的早期诊断寻找更为可靠的检查手段和依据。方法根据高原反应症状评分以及典型症状,对24200例急进高原人员进行筛查,对其中162例HACE疑似病例进行随访观察,进行了脑CT、MRI检查;并对最后确诊为HACE病例的CT及MRI的动态变化进行分析。结果在这些HACE疑似病例中,有36例患者最后确诊为HACE。22例(61.1%)HACE患者在未出现精神、神经症状时,即有MRI异常表现,以脑实质内T1WI低信号和T2WI高信号的斑点状或小片状改变为主,而同时CT仅有1例异常(2.8%)。结论 HACE早期MRI表现以脑实质内T1WI低信号和T2WI高信号的斑点状或小片状改变为主。与CT相比,MRI更有助于HACE的早期诊断。Objective To explore the pulmonary image of high altitude cerebral edema（HACE）in early stage,and to find a more reliable method of early diagnosis of HACE.Methods 24 200 people who arrived at high altitude rapidly were screened according to high altitude reaction scale and typical symptoms.Among them,142 suspected HACE cases were further observed and received CT and MRI examination.The dynamic changes of CT and MRI in the patients who diagnosed finally as HACE were analyzed.Results There were 36 cases diagnosed finally as HACE in these suspected HACE cases;22（61.1%）HACE patients showed abnormal MRI manifestation before the occurrence of spiritual or nervous symptoms.The main manifestation of MRI in early stage of HACE was spots or small flake-like changes of T1WI low signal and T2WI high signal within brain parenchyma,whereas only one case（2.8%）showed CT abnormality at the same time.Conclusion The main manifestation of MRI in the early stage of HACE is spots or small flake-like changes of T1WI low signal and T2WI high signal within brain parenchyma.MRI is more helpful to the early diagnosis of HACE compared with CT.

关 键 词：高原 高原脑水肿 早期诊断 CT MRI 

分 类 号：R594.3[医药卫生—内科学]