延髓背外侧综合征的临床表现与MRI诊断价值  

Clinical manifestation and value of magnetic resonance imaging in the diagnosis of lateral medullary syndrome

作　　者：刘俊杰[1] 

机构地区：[1]郑州市第三人民医院磁共振科,郑州450003

出　　处：《中国实用神经疾病杂志》2014年第23期102-102,114,共2页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨磁共振与延髓背外侧综合征的临床表现关系。方法分析我院100例2008-2013年有延髓背外侧综合征的患者临床资料及头部MRI检查表现。结果眩晕、头晕94%,半身感觉障碍92%,面部感觉障碍85%,步态共济失调86%,恶心、呕吐76%,吞咽困难64%,声嘶56%,Horner征74%;常规行MRI、扩散加权成像(DWI)及三维时间飞跃法(3D-TOF)血管成像,分析病灶累及部位和各序列的MRI特征,MRI结果显示,延髓上部损害是斜带型,常伴随严重的吞咽困难、声嘶和面瘫的临床表现;延髓下部的损害常位于延髓外侧的表面,表现为眩晕、眼震和步态共济失调。结论磁共振表现的受累部位与延髓背外侧综合征的临床特点相关,MRI为临床提供有力的证据,临床大夫可尽早治疗,改善预后效果。Objective To explore the correlations of clinical manifestation and magnetic resonance imaging in the diagnosis of lateral medullary syndrome .Methods Clinical data and of cranial MRI of 100 lateral medullary syndrome patients from 2008 to 2013 in our hospital were analyzed .Results Vertigo/dizziness 91% ,sensory dysfunction bust in 92% ,facial sensory disturb‐ances 85% ,gait ataxia 86% ,nausea vomiting 76% ,dysphagia 64% ,hoarseness 56% ,Horner syndrome 74% .All the patients were scanned by MRI ,DWI and 3D‐TOF‐MRA ,and the lesions involving the site and MRI characteristics of each sequence were analyzed .MRI results showed that the type of upper damage of medulla was inclined band .It is often accompanied by dyspha‐gia ,hoarseness ,and facial paralysis .The damage of lower part of the medulla oblongata often locates in the outside surface ,and clinical manifestations are dizziness ,nystagmus and gait ataxia .Conclusion The affected area in MRI is associated with the clin‐ical features of lateral medullary syndrome .MRI can provide strong evidence for clinical application and the treatment can be performed as early as possible which contributes to improve the prognosis .

关 键 词：延髓背外侧综合征 磁共振成像 扩散加权成像 磁共振血管造影 

分 类 号：R741.04[医药卫生—神经病学与精神病学]