不同亚型多系统萎缩患者磁共振成像特征分析  

Magnetic resonance imaging features of patients with different subtypes of multiple system atrophy

作　　者：翟飞[1] 胡晨[1] 张素杰[1] 

机构地区：[1]天津医科大学总医院,天津300052

出　　处：《山东医药》2013年第20期36-38,共3页Shandong Medical Journal

基　　金：天津市卫生行业重点攻关项目(12KG132)

摘　　要：目的分析多系统萎缩(MSA)不同亚型的磁共振成像(MRI)特征,并探讨其意义。方法选择MSA患者32例,其中15例行MRI,并用日常生活活动能力(ADL)的3个重要事件对疾病进展进行评估。结果 13例小脑萎缩型(MSA-C)患者中,MRI检查脑桥十字征0期2例、Ⅰ期1例、Ⅱ期2例、Ⅲ期4例、Ⅳ期3例、Ⅴ期1例,壳核裂隙征分期均为0期;2例帕金森型(MSA-P)患者脑桥十字征和壳核裂隙征分期均为0期。13例MSA-C患者中,5例脑桥十字征未达Ⅲ期者,行走不稳3例,其中1例为辅助行走状态;4例Ⅲ期者均行走不稳,其中2例需辅助行走;3例Ⅳ期者中,辅助行走1例,依靠轮椅2例;1例V期者依靠轮椅。2例MSA-P患者中,可独立行走1例,辅助行走1例。结论头部MRI脑桥十字征、壳核裂隙征有助于MSA亚型的鉴别,且影像学特征分期与病情进展程度有一定关系。Objective To analyze the magnetic resonance imaging（MRI） features of different subtypes of multiple system atrophy（MSA） and to investigate its significance.Methods A total of 32 patients with MSA were retrospectively analyzed,during whom 15 patients underwent magnetic resonance imaging（MRI） in our hospital.Three aspects o f activities of daily living（ADL） were used to assess the progression of disease.Results During 13 patients with MSA-C,2 cases showed no ＂cross sign＂（stage 0） within 9 months,1 case showed stage Ⅰ,2 cases showed stage Ⅱ,4 cases showed stage Ⅲ,3 cases showed stage Ⅳ and 1 case showed stage Ⅴ,and all the 13 patients with MSA-C showed stage 0 ＂putaminal slit＂;2 patients with MSA-P showed stage 0 ＂cross sign＂ and ＂putaminal slit＂.During 13 patients with MSA-C,5 cases of cross sign didn′t reach stage Ⅲ,walking instability in 3 cases,including 1 cases of auxiliary walking state;4 cases in stage Ⅲ were walking instability,among which 2 patients needed assisted walking;3 cases in stage Ⅳ,among which 1 case needed assisted walking,2 cases needed wheelchairs;1 case in stage V was in a wheelchair.In 2 patients with MSA-P,1 patients could walk independently and 1 case needed auxiliary walking.Conclusions The combination of clinical manifestations and MRI examination contribute to the diagnosis of MSA and its subtypes.The stages of MRI may have a relationship with the progression of clinical symptoms.

关 键 词：多系统萎缩 磁共振成像 十字征 壳核裂隙征 

分 类 号：R742[医药卫生—神经病学与精神病学]