获得性肝性脑部变性的影像学诊断及临床分析  

Imaging diagnosis and clinical analysis of acquired hepatocerebral degeneration

作　　者：楼晓剑[1,2] 蒋定尧[1] 俞高龙[2] 

机构地区：[1]浙江大学医学院第二附属医院放射科,浙江杭州310009 [2]解放军113医院放射科

出　　处：《实用放射学杂志》2012年第8期1179-1182,共4页Journal of Practical Radiology

摘　　要：研究获得性肝性脑部变性（AHCD）的CT和MRI表现。方法 对20例经临床、CT和MRI诊断后随访确诊的病例进行分析,其中10例同时行腹部MRI或CT扫描。结果 20例AHCD中,MRI均示有异常改变：主要显示基底节及脑干区快速自旋回波（TSE）T1WI对称性高信号,其中双侧苍白球19例,壳3例,尾状核5例,中脑红核周围15例,大脑脚5例、脑桥3例,垂体前叶8例。TSET2WI信号正常12例,稍高信号6例,高信号2例,扩散加权信号正常15例,高信号5例。结论 MRIT1WI双侧基底节及中脑等部位出现高信号影,是AHCD较为特征性的影像学表现,MRI是发现这些病变最敏感的方法 。结合临床病史,绝大部分病例可明确诊断。Objective To evaluate CT an MR imaging findings of acquired hepatocerebral degeneration （AHCD）. Methods Twenty cases with AHCD diagnosed by clinic, CT, MRI and corifirmed by follow-up were retrospectively analyzed. 10/20 cases underwent abdominal MR or CT scan simultaneously. Results Among the 20 cases, the abnormalities found by MR imaging were mainly symmetrical high signals in basal ganglia and brain stem, including globus pallidus in 19, putamen in 3, caudate nucleus in 5, surroundings of mesocerebrum and red nucleus in 15, cerebral peduncles in 5, pontine in 3 and anterior pituitary in 8 cases on TI WI. Normal signal in 12, slighty high signal in 6, high signal in 2 on T2WI and normal signal in 15, high signal in 5 cases on DWI were detected. Conclusion In AHCD, hyperintense on T1WI in certain region（such as bilateral basal ganglia and brain stem） is the char acteristic imaging finding, which is sensitive to detect by MR imaging, most cases of AHCD can be diagnosed correctly according to the MRI characteristic findings.

关 键 词：脑 肝性脑部变性 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] R575.3[医药卫生—临床医学]