急性型胼胝体变性的临床表现和影像学特点  

Clinical and imaging characteristics of acute marchiafava-bignami disease

作　　者：杨德[1] 李鱼[1] 杨晓苏[2] 何亮[1] 陈科宇[1] 

机构地区：[1]重庆市涪陵中心医院神经内科,408099 [2]中南大学湘雅医院神经内科,长沙410008

出　　处：《重庆医学》2015年第8期1060-1062,共3页Chongqing medicine

摘　　要：目的探讨急性型胼胝体变性(MBD)的临床表现和影像学特点。方法对该院诊治的3例急性型MBD患者进行回顾性分析,包括临床表现、实验室检查、影像学检查(头颅CT、MRI)和随访结果。结果 3例患者均急性起病,主要表现为意识障碍、精神异常、癫痫发作、谵妄性震颤、高热等;CT与MRI可见胼胝体膝部和压部病灶,CT示病灶为低密度,MRI表现为T1WI等或低信号,T2WI高信号,液体衰减反转恢复序列高信号,弥散加权成像(DWI)高信号,ADC等或低信号;3例均伴发双侧大脑半球白质对称性病灶,1例出现脑桥臂对称性病灶,1例胼胝体膝部及体部出现类似"三明治"样改变。结论急性型MBD临床表现多样,无特异性,但具有特征性影像学表现。Objective To investigate the presentation and radiologic findings of acute marchiafava‐bignami disease（MBD） . Methods Three cases of acute MBD who were diagnosed and treated in our hospital were retrospectively analyzed ,including the clinical symptoms ,laboratory tests ,imaging examination（such as cranial CT ,magnetic resonance imaging（MRI） ,prognosis .Results Three cases were acute onset .The symptoms may be non‐specific ,such as consciousness disorder ,psychosis ,seizures ,delirium tremor and high fever .The imaging changes in the genu and splenium of corpus callosum could be found ,even in the bihemispheric white matter of all cases .CT revealed low‐density areas ,meanwhile MRI showed iso‐or hypo‐intensity on T1WI and ADC ,hyper‐in‐tensity on T2WI and fluid attenuated inversion recovery and restricted diffusion weighted imaging .The lesions involved in bihemi‐spheric brachium pontis in one case and in the body of corpus callosum in another case .Conclusion Acute MBD may present with various clinical forms ,but have characteristic imaging findings .

关 键 词：胼胝体变性病 磁共振成像 电子计算机X线断层扫描 

分 类 号：R744.5[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学] R816.1