儿童脑白质营养不良的磁共振成像(MRI)表现  

The Features of the Magnetic Resonance Imaging(MRI) of Children Leukodystrophies

作　　者：杨开颜[1] 肖江喜[1] 蒋学祥[1] 周元春[1] 

机构地区：[1]北京医科大学第一医院医学影像科,北京100034

出　　处：《实用放射学杂志》2001年第5期327-332,共6页Journal of Practical Radiology

摘　　要：目的　探讨儿童脑白质营养不良较特征的MRI表现 ,以期为临床诊断提供一定的帮助。方法　对 5 0例脑白质营养不良患儿进行MRI检查 ,将获得的图像按病变累及脑叶的情况和累及脑内特殊结构的情况进行分析。结果　 1.ALD以顶枕叶白质受累为主 ,MLD除累及顶枕叶外 ,额叶受累的机会也较多 ,而CD和PMD则累及全脑叶 ,AD以先累及额叶为主。ALD以中央白质受累为主 ,MLD仅累及中央白质而周边白质未受累 ,CD、PMD和AD中央及周边白质均受累。ALD和CD较易累及小脑白质。 2 .ALD主要累及胼胝体压部 ,MLD则常累及胼胝体全部 ,而CD、PMD、GLD和AD一般均不累及胼胝体 ;ALD以累及内囊后肢后部为主 ,MLD则内囊后肢后部和前部均累及 ,PMD较CD有更多的机会累及内囊全部 ;对于外囊 ,ALD以累及其后部为主 ,而CD和PMD均累及外囊全部 ;累及脑干皮质脊髓束是ALD的一个显著特征 ,除 1例晚发型GLD外 ,其余脑白质病变均未累及脑干皮质脊髓束。另外 ,ALD也较易累及中脑外侧丘系 ,ALD、MLD和PMD累及丘脑的机会也较多。结论　MRI为一种无创、安全和敏感的发现早期脑白质病变的影像学方法 ,不同脑白质营养不良的MRI表现有一定的特征性 。Objective To detect the features of MRI of children leukodystriphies and to provide a heplful method for clinical diagnosis.Methods The MRI examination was performed in 50 children with leukodystrophies and the cerebral lobes and cerebral special structures involved by lesions were analyzed.Results 1.There were dominant signs of involving parietal and occipital lobes in ALD,besides the two lobes,the frontal lobe was also involved easily in MLD.All lobes were involved in CD and PMD,and frontal lobe was involved in AD early.The central white matter was involved mainly in ALD,but the central white matter was involed only in MLD and the periphery white matter was spared.The central and periphery white matter were all involved in CD,PMD and AD.Furthermore,the cerebellar white matter is also easily involved in ALD and CD.2.The splenium of corpus callosum was mainly involved in ALD,and the splenium,body and knee of corpus callosum were all involved in MLD.But in CD,PMD and AD,the corpus callosum was spared.The back of the posterior limb of internal capsule was involved in ALD,but the all posterior limb of internal capsule was involved in MLD,and the all internal capsule was involved in CD and PMD.On external capsule,ALD involves its posterior part,but CD and PMD involve its all section.A prominet feature of ALD was involving the corticospinal tract of stem and other leukodystrophies don′t involve the corticospinal tract of stem beside one case later-onset GLD.In addition,the lateral lemmiscus was involved easily in ALD,and thalamus was also involved in ALD,MLD and PMD.Conclusion As a noninvasive,safe and sensitive method,MRI can be used to find the leukodystrophies early.There are relatively characteristic features in different leokodystrophies,which is useful to clinical diagnosis.

关 键 词：磁共振成像 脑白质营养不良 儿童 MRI 

分 类 号：R445.2[医药卫生—影像医学与核医学] R742.8[医药卫生—诊断学]