脑皮质层状坏死的MR诊断  

The MR diagnosis of cortical laminar necrosis

作　　者：李晓夫[1] 高颖[2] 赵明[1] 张铁成[1] 付旷[1] 

机构地区：[1]哈尔滨医科大学附属第二医院磁共振成像诊断科,黑龙江哈尔滨150086 [2]哈尔滨工业大学医院放射科,黑龙江哈尔滨150001

出　　处：《医学影像学杂志》2011年第8期1129-1131,共3页Journal of Medical Imaging

摘　　要：目的:探讨脑皮质层状坏死(cortical laminar necrosis,CLN)的MRI表现特点。方法:回顾性分析13例经我院神经内科及儿内科确诊为脑皮质层状坏死患者MRI表现及临床资料,总结其影像学特点。结果:所有病例在发病后MRI均有异常表现,病灶区呈层状短T1、长T2改变(13/13),其中6例(6/13)呈短T1、长T2改变出现在病灶侧皮质表面或沿脑回走行;3例(3/13)同时出现在病灶侧皮质表面或沿脑回走行、病灶侧基底节区和皮质下;2例(2/13)仅出现在病灶侧基底节区和皮质下;2例(2/13)呈斑点状出现在病变区内。FLAIR像上均呈高信号(13/13),即使T1WI高信号消失后,FLAIR高信号仍可持续1年左右(2/13)。DWI像上有9例(9/13)表现为弥散受限,呈高信号或稍高信号,较T1WI高信号显示病变范围更广有3例(3/13)。GD-DTPA早期即可明显强化,多呈线样、脑回样强化。结论:引起脑皮质层状坏死的病因较多,影像学上有特征性改变,T1WI脑回样高信号和长时间FLAIR高信号是其特异征象,结合临床病史,不难做出准确诊断。Objective：To study the MRI imaging features of cortical laminar necrosis. Methods：A retrospective analysis of the MRI imaging features and clinical data of 13 cases of cortical laminar necrosis patients diagnosed at our department of neurology and department of pediatrics was performed, with a view to summarize their imaging characteristics. Results：All 13 cases showed abnormal MRI manifestations of laminar short T and long T2 changes, among which 6 exhibited MRI short T1 and long T2 changes over the lateral cortical surfaces or along the gyri; 3 exhibited MRI short T1 and long T2 changes over the lateral cortical surfaces or along the gyri, in the basal ganglia areas as well as in the subcortical areas; 2 exhibited MRI short T; and long T2 changes only in the basal ganglia areas and the subcortical areas. 2 cases exhibited speckled distribution in the lesions zone. FLAIR showed high signal in all 13 cases. Even after T1WI high signal disap pears, FLAIR high signal could still persist for about a year （2/13）. DWI showed 9 cases with restricted diffusion, and high signal or slightly high signal. An earlystage GDDTPA can show significant contrast, linear or gyrate. Conclusion： Cortical laminar necrosis may have various causes, but imaging can help reveal characteristic changes in the lesions zone. T~ WI gyrate high signal and FLAIR long time high signal are its characteristic signs. With the help of the review of clini cal history, accurate diagnosis is highly possible.

关 键 词：脑皮质层状坏死 磁共振成像 神经疾病 

分 类 号：R742[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]