磁共振成像在脑桥梗死诊断中的价值  

Value of MRI for the diagnosis of pontine infarction

作　　者：殷雁[1] 金钰[1] 孙庆华 尹琳[1] 

机构地区：[1]大连医科大学附属第二医院神经内科,116027 [2]大连市中山区人民医院神经内科

出　　处：《中华老年心脑血管病杂志》2012年第12期1289-1292,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨脑桥梗死的临床与MRI特征。方法回顾性分析96例脑桥梗死患者的临床资料,评估危险因素,分析临床与MRI特点。结果首发临床表现复杂多样,96例患者中,头晕或眩晕79例(82.29%),肢体活动不便76例(79.17%),构音障碍54例(56.25%),中枢性面瘫49例(51.04%),感觉障碍31例(32.29%),中枢性舌瘫25例(26.04%)等表现最常见;多表现为病灶对侧的中枢性面瘫和(或)舌瘫合并肢体瘫和(或)无感觉障碍,而经典脑桥综合征3例(3.13%);病灶在脑桥上段21例(21.88%),中段62例(64.58%),下段13例(13.54%);腹内侧41例(42.71%),腹外侧22例(22.92%),中部16例(16.67%),背内侧11例(11.46%),背外侧6例(6.25%)。结论脑桥梗死常见临床表现为头晕或眩晕,肢体活动受限,构音障碍,中枢性面瘫,感觉障碍,中枢性舌瘫。交叉症状或体征在脑桥梗死患者中并不常见,经典的脑桥综合征病例少见。脑桥梗死以中段最常见,尤其是腹内侧。MRI对脑桥梗死的诊断有极其重要的意义。Objective To study the clinical and MRI features of pontine infarction. Methods The clinical data about 96 patients with pontine infarction were retrospectively analyzed. Its risk factors were assessed. Clinical and MRI features of pontine infarction were analyzed. Results Among the 96 patients with different clinical manifestations, dizziness or vertigo was found in 79 （82.29%） ,limb paralysis in 76 （79. 17%）, barylalia in 54 （56. 25%）, central facial palsy in 49 （51.04%） ,sensory disturbance in 31（32.29%）,central tongue palsy in 25（26.04%） respectively. Pontine infarction was usually manifested as contralateral central facial and/or tongue palsy accompanying limb paralysis and/or sensory disturbance. Three patients were diagnosed with classical pontine syndrome. Lesions were found in the upper,middle and lower pontine of 21（21.88%）, 62（64.58%） and 13（13.54%）patients,respectively,and in the ventral,lateral,central,dorsal and dorsal lateral medial portions of 41 （42. 71%）, 22 （22. 92%）, 16 （16. 67%）, 11 （11.46%）, and 6 （6.25%） patients,respectively. Conclusion Pontine infaction is usually manifested as dizziness/ vertigo, limb paralysis, central facial palsy, barylalia, sensory disturbance, and central tongue palsy. Cross symptoms or signs are uncommon in pontine infarction patients and patients with classical pontine syndrome are rarely encountered. Pontine infarction usually occurs in middle segment, especially in the ventral medial portion. MRI plays an extremely important role in the diagnosis of pontine infarction.

关 键 词：脑梗死 脑桥 眩晕 偏瘫 磁共振成像 

分 类 号：R743.33[医药卫生—神经病学与精神病学]