MELAS综合征的临床和功能MRI分析  

The analysis on clinical and functional MRI of MELAS

作　　者：时雅辉 赵建华[1] 宋金玲[1] 李月娟[2] 梁珂[1] 

机构地区：[1]河南省人民医院神经内科,河南郑州450000 [2]黄河中心医院神经内科,河南郑州450000

出　　处：《中风与神经疾病杂志》2016年第5期442-444,共3页Journal of Apoplexy and Nervous Diseases

摘　　要：目的探讨MELAS综合征的临床和功能MRI特点,提高早期诊断率。方法收集39例最终确诊为MELAS综合征患者的临床表现、实验室检查及影像学资料。结果患者首发症状为癫痫、语言障碍、偏瘫、头痛等。病灶区DWI呈高信号,ADC图随病程发展可呈高信号、低信号及高低信号并存。10例MRA均无明显血管狭窄。PWI急性期灌注增高,慢性期灌注减低。6例氢质子波谱（1~H-MRS）病变区均可见倒置双乳酸峰。SWI部分患者双侧基底节区在磁敏感加权图像中呈低信号影。结论 MELAS综合征临床表现复杂多样,缺乏特异性,常规MRI检查对于病变的筛选有很大的意义,功能MRI具有特征性表现,有助于提高该病早期诊断率。Objective To explore the clinical and MRI functional characteristics of MELAS in order to improve the early diagnosis rate. Methods Clinical features,laboratory tests and imaging data of 39 patients with final diagnosis of MELAS were collected. Results The main clinical features were epilepsy,language barrier,hemiplegia,headache and so on. DWI of the lesion area showed a high signal,ADC chart with the course of disease development can could be a high signal,low signal,or mixture of high and low signal. 10 cases of MRA,There was no obvious vascular stenosis in MRA of 10 cases. The acute phase of PWI perfusion increased,and whileas the chronic phase was decreased. 6 patients were examined with MRS,the lesions showed inverted double lactate peak. In some patients,bilateral basal ganglia showed a low signal intensity in the magnetic susceptibility weighted images. Conclusions The clinical manifestations of MELAS patients are complex and various,and lack of specificity,routine MRI examination is of great significance for the screening of the lesion,functional MRI has a characteristic performance,It is helpful to improve the early diagnosis rate of the disease.

关 键 词：MELAS 影像学 MRI MRA DWI ADC图 PWI SWI MRS 

分 类 号：R746.9[医药卫生—神经病学与精神病学] R743[医药卫生—临床医学]