亚急性1,2-二氯乙烷中毒性脑病的MR表现特征  

Cranial MRI characteristics in patients with suspected subchronic 1,2-DCE toxic encepha-lopathy by inhalation

作　　者：陈彩虹[1] 杨建生[1] 程建敏[1] 陈博[1] 王小同[2] 谢筱筱[1] 严志汉[1] 虞志康[1] 毛传万[1] 陈旺强[1] 

机构地区：[1]温州医学院附属第二医院放射影像科,浙江温州325027 [2]温州医学院附属第二医院神经内科,浙江温州325027

出　　处：《温州医学院学报》2012年第3期257-259,共3页Journal of Wenzhou Medical College

摘　　要：目的 :探讨亚急性1,2-二氯乙烷(l,2-DCE)中毒性脑病的MR特征。方法:回顾性分析2006年7月至2010年12月本院收治的13例亚急性1,2-DCE中毒性脑病患者的MR影像及临床资料,观察其MR表现特征。结果:患者均为亚急性起病,有1,2-DCE密切接触史,临床表现无特征性,腰穿检查示脑脊液压力增高。MR改变十分相似,13例均表现双侧大脑半球脑白质明显的对称性受累,以皮层下U形纤维脑白质区为著,呈火焰样改变;双侧外囊区呈对称条弧形影。深部脑灰质包括双侧苍白球(13例)、上部丘脑区(5例)、小脑齿状核(13例)均对称受累,呈长T1、长T2信号。旁矢正中层面T2WI图像均见典型"双核高信号"(13例)。结论:亚急性l,2-DCE中毒性脑病的MR表现具特征性,对临床诊断具有重要的参考价值。Objective： To investigate the cranial MRI characteristics in patients with toxic encephalopathy induced by 1,2-DCE,and to evaluate the role of MRI in diagnosis.Methods： MR findings and medical records of 13 patients [1 male and 12 female;age range 18-30 years（mean 22 years）] with toxic encephalopathy induced by 1,2-DCE were retrospectively studied.Results： Thirteen patients all presented with subacute onset with a history of direct exposure to 1,2-DCE.Lumbar cerebrospinal fluid pressures were all increased in 13 patients.Cranial MRI showed diffuse T1WI low signal and T2WI high signal in bilateral hemispheric white matter involving mainly subcortical white matter with sparing of the cortex and internal capsule,meanwhile demonstrating bilateral similar symmetrical cerebellar dentate nucleus and globus pallidusi were involved with sparing of cerebellar white matter in all 13cases.Conclusion： The typical neuroradiologic aspect of 1,2-DCE may be helpful for the diagnosis,1,2-DCE has a distinct highly characteristic pattern of MR imaging abnormalities：a combination of symmetricity of predominantly subcortical cerebral WM abnormalities and bilateral distribution abnormalities of the dentate nucleus,globus pallidus.Early identi-fication can lead to prompt and appropriate management.

关 键 词：二氯乙烷类 白质脑病 磁共振成像 

分 类 号：R595.1[医药卫生—内科学] R598[医药卫生—临床医学]