MELAS型线粒体脑肌病的脑部MRI表现（附三例报道）  

MRI appearance of mitochondrial encephalomyopathy combined with lactic acidosis and stroke like episodes： a report of 3 cases

作　　者：林志春[1] 赵永青[2] 陈燕萍[3] 张雪林[3] 

机构地区：[1]天津武警医学院附属医院PET-CT中心,天津300162 [2]天津武警医学院附属医院脑系中心,天津300162 [3]南方医科大学南方医院影像中心,广州510515

出　　处：《中华神经医学杂志》2010年第11期1164-1166,共3页Chinese Journal of Neuromedicine

摘　　要：目的 总结分析MELAs型线粒体脑肌病的脑部MRI表现.方法 回顾性分析3例MELAS型线粒体脑肌病患者的临床资料和MRI表现.结果 MRI显示MELAS型线粒体脑肌病表现为以颞叶、顶、枕叶为主的皮层及皮层下白质病变,病变多呈双侧非对称性分布,部分患者以累及基底节为主要表现,T2WI和液体衰减翻转恢复序列对病变的显示有独特的作用,DWI、ADC图及增强扫描能够诊断及鉴别诊断线粒体脑肌病及卒中,MRS对其诊断可以起到辅助作用.结论 MELAS型线粒体脑肌病在MRI图像上具有特征性,MRI影像表现结合临床资料对本病多能作出正确的诊断.Objective To investigate the MRI features of patients with mitochondrial encephalopathy combined with lactic acidosis and stroke-like episodes （MELAS）. Methods The clinical data and MRI images of 3 patients with MELAS were retrospectively analyzed and related literatures were reviewed. Results As shown by MRI images, the temporal, parietal and occipital lobes of brain were the main attacked areas in patients with MELAS. A double and dissymmetrical lesion could be found in the cortical and subcortical white matter. However, as for some patients, the lesion might primary invaded the basal ganglia of brain. The T2WI and the fluid-attenuated inversion recovery （FLAIR） sequences had a special role in revealing the lesions; while the DWI, apparent diffusion coefficient （ADC） map and enhancement scanning helped in diagnosing and distinguishing MELAS from cerebral stoke, and MRS played an assisted role for its diagnosis. Conclusion Due to the characteristic MRI appearance of MELAS, MR imaging and related clinical data can help make a correct diagnosis for this disease.

关 键 词：线粒体脑肌病 MELAS综合征 磁共振成像 

分 类 号：R746[医药卫生—神经病学与精神病学]