MELAS型线粒体脑肌病的多模态MRI诊断  

Diagnosis of multimode magnetic resonance imaging in MELAS

作　　者：黄春元[1] 杨智云[2] 许朝璇[1] 侯瑜[1] 陈素云[1] 吴倩红[1] 赵志清[1] 罗帝林[1] 

机构地区：[1]广州医科大学附属深圳沙井医院放射科,广东深圳518104 [2]中山大学附属第一医院放射科,广东广州510080

出　　处：《中国临床医学影像杂志》2014年第8期533-537,共5页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨MELAS型线粒体脑肌病的多模态影像学特点。方法:对11例MELAS型线粒体脑肌病患者的脑MRI、MRA、DWI及MRS影像资料进行分析。结果:MRI:MELAS病灶多位于枕顶叶大脑皮层,多发为主,多变性、游走性,与血管的走行不一致,5例海马、海马旁回受累,5例合并基底节核团受累,4例合并大脑和(或)小脑萎缩,7例增强扫描未见强化;MRA:1例病灶处动脉分支增多,6例未见异常;DWI:5例均为高和(或)稍高信号,ADC图为稍高信号2例、稍低信号2例、稍高等稍低混杂信号1例;MRS:病灶区及对侧正常区均可见升高的乳酸(Lac)双峰,病灶区与对侧正常区比较Lac及Lac/Cr均明显增高(P<0.001)。结论:MELAS型线粒体脑肌病的多模态MRI表现有一定特异性,综合分析,可提示诊断。Objective： To investigate multimode magnetic resonance finding imaging in the patients with MELAS type of mitochondrial encephalomyopathy. Methods： MRI, MRA, DWI and MRS manifestations of 11 cases with MELAS were retro- spectively analyzed. Results： In 11 cases, the lesions were mainly distributed in the cortical zones of occipital and parietal lobe, hippocampus, parahippocampal gyrus were involved in 5 cases, and basal ganglia involvement in 5 cases too. The distri- bution of the lesions was muhip]e, wandering and variable, and the location was not corresponding with the vascular supply territories. Four cases presented cerebellum and（or） cerebellar atrophy. Seven cases showed no enhancement after contrast scan- ning. In 1 of the 7 cases with MRA, there were increased arterial branches of the lesions zone, other 6 cases were normal, In 5 cases, the lesions showed hyperintensity and（or） slight hyperintensity on DWI, slight hyperintensity（2 cases） or hypointen- sity（2 cases） or mix-intensity （1 case） on ADC images. The focal lesions and relatively normal areas showed increasing Lac peak on ~H-MRS. The quantitative analysis manifested that the value of Lac and Lac/Cr were obviously increased（P〈0.001） in the focal lesions than the normal areas. Conclusion： Muhimode magnetic resonance image is relatively specific to MELAS and can make diagnosing MELAS with comprehensive analysis.

关 键 词：线粒体脑肌病 MELAS综合征 磁共振成像 

分 类 号：R746[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]