MRI诊断一氧化碳中毒性脑病  

MRI in diagnosis of carbonic oxide toxic encephalopathy

作　　者：杨松[1] 李冰城 王忠平[1] 徐霖[1] 陈伦刚[1] 陈学强[1] 陈海波[1] 

机构地区：[1]太和医院湖北医药学院附属医院放射影像中心,湖北十堰442000

出　　处：《中国介入影像与治疗学》2014年第7期419-422,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的探讨一氧化碳(CO)中毒性脑病的MRI特征。方法回顾性分析38例CO中毒性脑病患者的影像学资料,17例为急性CO中毒性脑病,21例为急性CO中毒后迟发性脑病,观察其MRI特征。结果共26例苍白球受累,其中急性CO中毒性脑病占53.85%(14/26),CO中毒后迟发性脑病占46.15%(12/26);25例脑白质受累,其中急性CO中毒性脑病占20.00%(5/25),CO中毒后迟发性脑病占80.00%(20/25);苍白球和(或)脑白质受累伴小脑和大脑皮质受累各1例,伴胼胝体受累9例。4例苍白球受累者T1WI呈稍高及高信号,其他病变区域T2WI呈稍高及高信号,T1WI呈等低信号。10例CO中毒后迟发性脑病患者接受DWI,其中6例脑白质受累,病变区ADC值减低;4例脑白质和苍白球同时受累,病变区ADC值升高;3例伴胼胝体受累,病变区ADC值减低。2例CO中毒后迟发性脑病患者接受SWI,均显示苍白球受累,双侧苍白球呈对称性不均匀低信号。结论 CO中毒性脑病MRI具有典型特征,对评估病情及预后具有重要价值。Objective To evaluate MRI features of carbonic oxide （CO） toxic encephalopathy. Methods MRI data of 38 patients of CO poisoning, including 17 of acute CO poisoning and 21 of delayed encephalopathy after acute CO intoxication were retrospectively analyzed, and their MRI features were observed. Results There were 26 cases with globus pallidus in- volved, including 14 （14/26, 53.85 %） of acute CO intoxication and 12 （12/26, 46.15 %） of delayed encephalopathy after acute CO intoxication. There were 25 cases with white matter involved, including 5 （5/25, 20.00%） of acute CO intoxica- tion and 20 （20/25, 80.00%） of delayed encephalopathy after acute CO intoxication. The involvement of corpus callosum was observed in 9 patients, while of cerebellar hemisphere and brain cortex were noticed in 1 patient, respectively. The le- sions showed slightly high or high signal on T2WI and low signal on T1WI, except for 4 patients with globus pallidus in- volvement showing slightly high or high signal on T1WI. Among 10 patients with delayed encephalopathy after acute CO intoxication who underwent DWI, decrease of ADC values were displayed in brain white matter in 6 and corpus callosum re- gions in 3 patients, while increase of ADC values were found in brain white matter and globus pallidus regions in 4 patients with both two regions involvement. Two patients with delayed encephalopathy after acute CO intoxication underwent SWI, showing symmetrica! heterogeneous hypointensity in bilateral globus pallidus. Conclusion CO toxic encephalopathy has typical characteristics on MRI, which is of great value in assessing the state and prognosis.

关 键 词：一氧化碳 中毒 弥散磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R595.1[医药卫生—诊断学]