1，2-二氯乙烷中毒性脑病的影像学表现  

Imaging features of toxic encephalopathy induced by 1, 2-Diehloroethane

作　　者：刘靖[1] 朱希松[2] 高欣[1] 徐雪原[1] 赵洪波[1] 陶晓峰[3] 

机构地区：[1]第二军医大学附属长征医院影像科,上海,200003 [2]浙江省衢州市人民医院放射科 [3]上海市东方医院影像科

出　　处：《实用放射学杂志》2011年第9期1317-1320,共4页Journal of Practical Radiology

摘　　要：目的 探讨1,2-二氯乙烷中毒性脑病的CT、MR表现.方法 对6例临床具有脑病症状并且有1,2-二氯乙烷接触史的患者进行检查,检查包括神经学体检,CT,磁共振波谱（MR spectroscopy,MRS）,弥散加权成像（diffusion weighted imaging,DWI）,T1、T2加权成像及磁共振增强扫描.结果 5例进行CT检查的患者,病灶均表现为低密度,两侧对称.病灶大多累及两侧大脑半球白质（累及皮层下弓形纤维为主）、两侧齿状核、丘脑、苍白球.4例进行MRI检查的患者,均表现为上述部位广泛性T2加权高信号.CT、MRI都显示脑回肿胀,脑室系统受压变小.1例进行MR增强检查的病例未见明显异常强化.3例进行DWI检查的病例表现为双侧对称性高信号,病灶区域表观弥散系数（ADC）值降低.1例进行MRS检查的病例表现为：病灶NAA/Cr比值明显降低,而Cho/Cr比值升高.结论 神经系统体征及CT、MRI检查对1,2-二氯乙烷中毒性脑病有助于早期诊断,DWI及MRS还可以进一步反映病灶代谢改变.Objective To study the pattern of CT and MR imaging of toxic encephalopathy induced by 1, 2-DCE. Methods Six patients with encephalopathy symptom clinically and exposured to 1, 2-DCE underwent and neurologic examination, CT （5 cases）, MRS（one case）, DWI（3 cases） ,T1WI and T2WI （4 cases） and contrast-enhanced MR imaging（one case）. Results CT findings：the lesions appeared as low density and bilateral symmetry,and involving the white matter of cerebral hemisphere diffusely （mainly in subcortical arcuate fibers）, bilateral cerebellar dentate nuclei, thalamus and globus pallidus. MRI features：the lesions showed high signal intensity on T2 WI. Cerebral sulei swelling and compression or occlusion of the ventricles were seen on both CT and MRI. The lesions were no enhanced abnormality. The lesions were symmetrical high signal intensity on DWI. ADC values of the lesions were decreased. MR spectroscopy showed choline-containing compounds and N-acetylaspartate at the lesion regions decrease. Conclusion CT and MR imaging examinations are helpful in diagnosing the toxic encephalopathy induced by 1,2-DCE early. DWI and MRS can show dynamic metabolic changes.

关 键 词：二氯乙烷 脑 中毒性脑病 体层摄影术 X线计算机 磁共振成像 

分 类 号：R742[医药卫生—神经病学与精神病学] R814.42[医药卫生—临床医学]