甲苯中毒性脑病磁共振及功能性成像特征分析  

MRI and Functional Magnetic Resonance Imaging Features of Toluene Toxic Encephalopathy

作　　者：廖海波[1] 肖新兰[1] 戴中强 刘征华[1] 尹建华[1] 王志强[1] 于建华[1] 金文晶[1] 

机构地区：[1]南昌大学第二附属医院MRI室,300006 [2]广东省普宁市中医院CT室

出　　处：《临床放射学杂志》2014年第7期1096-1100,共5页Journal of Clinical Radiology

摘　　要：目的探讨甲苯中毒性脑病磁共振及其功能性成像表现。方法对3例甲苯中毒性脑病进行常规磁共振及其功能性成像检查。3例患者和7名健康女性志愿者均在3T GE MR扫描仪进行常规扫描及扩散加权成像(DWI)、扩散加权张量成像(DTI)、多体素氢质子波谱成像(3D1H-MRS)及行3D动脉自旋标记(3D-PCASL)检查。图像传送至GE 4.4工作站,使用Functool软件包,分别测量包括皮层下白质、双侧外囊、双侧苍白球、双侧丘脑及双侧齿状核平均表观扩散系数(ADC)值和平均各向异性分数(FA)值。3D1H-MRS选定白质内病灶为感兴趣区进行波谱分析。测量双侧白质区、皮层灰质及基底节区平均脑血流量(CBF)值。所有测量值均进行统计学分析。结果3例在磁共振平扫均表现为弥漫性、对称性脑白质及基底节区包括外囊、苍白球、丘脑T2WI异常高信号,同时累及小脑齿状核。3例苍白球平均ADC值较对照组明显下降并且具有统计学意义(P<0.05),病例2、病例3皮层下白质、外囊、丘脑及齿状核平均ADC值较对照组下降,但没有统计学意义。平均FA值在所有病例均下降并具有统计学意义(P<0.002)。3例白质内病灶波谱分析发现NAA/Cr比值下降而Cho/Cr值上升,且具有统计学意义(P<0.001)。所有感兴趣区平均CBF在中毒性脑病组和对照组无差异。结论甲苯中毒性脑病在磁共振检查上具有一定特征性表现,功能性成像可以显示脑组织细微结构变化和生化信息,有助于了解中毒性脑病病理机制。Objective To discuss MRI and functional magnetic resonance imaging （fMRI） features of toluene toxic encephalopathy. Methods Three patient with toluene toxic encephalopathy study group） and 7 health female volunteers （control group） were enrolled in this study. Traditional MRI scanning, DWI, DTI, 3D ^1H-MRS and 3D ASL examinations with a GE 3T MR unit were performed in all 3 patients and 7 volunteers. The raw data of DWI, DTI, 3D ^1H-MRS and 3D- PCASL were input to a GE 4.4 workstation and analyses of images were made with Functool software package. The mean ADC and FA values of the lesions and healthy tissues, including subcortex white matter, bilateral external capsules, bilateral pallidal globuses, bilateral thalami and bilateral dentate nucleuses, were measured. The mean CBF of white matter, gray matter and basal ganglia were also determined. The results were statistically analyzed. Results Compared to the control group, in 3 cases with toluene toxic encephalopathy plain MRI scanning showed diffuse symmetric abnormal high-intensity signals in cerebral white matter and basal ganglia area, including external capsules, pallidal globuses and thalami on T2WI. The mean ADC values of the study group were significantly decreased in bilateral pallidal globuses when compared with that of the control group （P 〈 0.05）. In case 2 and case 3, the mean ADC values of bilateral subcortex white matter, external capsules and dentate nucleuses were lower than those of the control group although the difference was not statistically significant. The mean FA values of the study group was significantly decreased, and the difference was statistically significant （P 〈 0. 002）. 3D ^1H-MRS analysis indicated that in three white matter lesions the NAA/Cr ratio was decreased while the Cho/Cr ratio was increased, and the difference was statistically significant （ P 〈 0. 001 ）. No statistically significant differences in the mean CBF at all regions of interest, including white matter, gray matter and basal ganglia

关 键 词：中毒性脑病 甲苯 磁共振成像 磁共振功能性成像 

分 类 号：R742[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]