Leigh综合征头颅质子磁共振波谱影像表现探讨  

Investigation of Spectrum on Brain Proton Magnetic Resonance Spectroscopy of Leigh Syndrome

作　　者：田树平[1,2] 杨立[2] 叶宏军[1] 王占宇[1] 花焱[1] 王子军[1] 张燕群[1] 郭勇[1] 

机构地区：[1]海军总医院放射科,北京100048 [2]解放军总医院放射科

出　　处：《临床误诊误治》2013年第3期63-65,共3页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨Leigh综合征头颅质子磁共振波谱(1H-MRS)的影像特点及诊断价值。方法对我院收治的临床诊断为Leigh综合征10例的头颅MRI及1H-MRS表现进行回顾性分析。结果本组10例双侧基底节区及中脑导水管周围灰质区、3例脑干背侧、1例小脑常规MRI检查均可见对称性长T1、长T2信号,FLAIR像上为高信号。弥散加权成像(DWI)7例显示高信号,扩散系数(ADC)图呈低信号;3例表现为等及低信号。10例灌注加权成像(PWI)示双侧豆状核、尾状核病灶均为高灌注,但其他部位病灶表现为低灌注。本组病变区域1H-MRS表现为胆碱峰升高,N-乙酰天门冬氨酸峰降低;病变区域、脑脊液及常规MRI图像表现正常的区域均可见巨大乳酸双峰。结论对Leigh综合征1H-MRS可提供直接反映疾病代谢异常的信息,联合应用常规MRI、DWI、PWI有利于该病的诊断和鉴别诊断。Objective To explore the characteristics and value of spectrum on brain proton magnetic resonance spectrosco- py （ 1 H-MRS） and its value in diagnosis of Leigh syndrome. Methods 1 H-MRS and MRI of 10 patients with Leigh syndrome in our hospital were retrospectively analyzed. Results Hyperintensity on T2WI/FLAIR and hypointensity on T1WI were presented in 10 patients＇bilateral basal ganglia and periaqueductal gray matter （PAG）, in 3 patients＇dorsal brain stem and in 1 patient＇s cerebellar nuclei. 7 patients showed hyperintense on diffuse weighing imaging （DWI） and hypointensity on diffusion coefficient （ADC） ; 3 pa- tients showed equal hypointensity. Perfusion weighted imaging （PWI） of 10 patients showed hypertransfusion on bilateral lenticular nucleus and caudate nucleus lesions, and hypoperfusion on the other positions of lesions. 1H-MRS of the Leigh syndrome cases showed elevated choline （Cho） peak and decreased N acetylaspartate （NAA） peak; huge two-humped lactates were presented in the diseased region, cerebrospinal fluid （CSF） and normal areas by routine brain MRI imaging. Conclusion t H-MRS may directly re- fleet the metabolism changes of Leigh syndrome, and may be helpful in diagnosis and differential diagnosis of the disease when com- bined with routine MRI, DWI and PWI.

关 键 词：LEIGH综合征 磁共振波谱学 磁共振成像 

分 类 号：R741[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]