非酮症高血糖偏身舞蹈症的颅脑CT及MRI表现  

Brain CT and MR findings of non-ketotic hyperglycaemia hemichorea

作　　者：唐乐梅[1,2] 苗延巍[2] 郑程程[2] 张竞文[2] 郎志谨[2] 

机构地区：[1]天津医科大学研究生院,天津300070 [2]大连医科大学附属第一医院放射科,大连116011

出　　处：《中国医学影像技术》2012年第10期1793-1796,共4页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金(81171321)

摘　　要：目的分析非酮症高血糖偏身舞蹈症患者脑实质的影像学表现。方法回顾性分析16例经临床确诊的非酮症高血糖偏身舞蹈症患者的脑部CT和MRI表现。16例患者均接受至少1次CT平扫,其中10例接受至少1次MR检查,10例治疗后接受复查。结果 16例CT均见基底节区片状或条形稍高或高密度影,T1WI表现为基底节区条形或片状稍高或高信号,边界较清晰;其中1例DWI示病变区为稍低信号,1例为等信号,前者ADC值升高,后者无明显改变,1例SWI幅度像及相位像均显示病变区局部为条、片状低信号,FLAIR未见异常信号,增强扫描未见强化。9例治疗后血糖降到正常范围,复查头部CT或MR,其中5例病变消失,1例病变明显缩小,3例未见改变。1例治疗后血糖轻度降低,头部CT显示病变密度增高。10例随诊病例中,2例于原病灶区出现腔隙性梗死表现。结论非酮症高血糖舞蹈病具有特征性影像学表现,通常提示2型糖尿病。Objective To analyze brain parenehyma imaging features of non-ketotic hyperglycaemia chorea. Methods CT and MRI of 16 patients with clinically-proved non-ketotic hyperglycemia chorea were analyzed retrospectively. All patients underwent plain CT, 10 underwent MR for at least one time. Ten patients were reexamined with CT or MRI. Results Le- sions in 16 non-ketotic hyperglycemia chorea patients all showed striatal or platy hyperdensity in basal ganglia on brain CT, and on TlWI with well-defined margin. One case revealed hypointencity, and the other revealed isointencity on diffusion- weighted imaging （DWI）. The former＇s value of apparent diffusion coefficient （ADC） rose, and the latter＇s had no change. Striatal or platy hypointeneity was detected on susceptibility-weighted imaging （SWI）. The signal had no change on pre-en- hancement and post-enhancement imaging. The lesion was not demonstrated on FLAIR imaging. After treatment, 9 pa- tients had normal blood glucose. Reexamined CT/MR showed the lesions disappeared in 5 patients and shrank in 1 patient, did not change in 3 patients. Blood glucose aggravated in 1 patient, and brain CT showed higher intensity of lesion. Lacu- nar infarction occurred in 2 of 10 patients who received follow-up. Conclusion Non-ketotic hyperglycemia chorea has char- acteristic CT and MRI features, which often refer to type 2 diabetes.

关 键 词：舞蹈症 糖尿病 酮病 体层摄影术 X线计算机 磁共振成像 

分 类 号：R814.42[医药卫生—影像医学与核医学] R445.2[医药卫生—放射医学]