常规MR诊断Wallerian变性的临床价值  

The clinical value of MRI in the diagnosis of Wallerian degeneration

作　　者：王东[1] 

机构地区：[1]河南大学附属南阳南石医院放射科,河南南阳473065

出　　处：《医学影像学杂志》2016年第7期1182-1184,共3页Journal of Medical Imaging

摘　　要：目的 探讨常规MRI在诊断脑损害后锥体束Wallerian变性中的价值。方法 对69例脑损害后锥体束Wallerian变性患者行MRI检查。常规行快自旋回波序列（FSE常规横断位、矢状位及冠状位扫描）：1.5T：T1WI FSE（TR550ms TE 15ms）T2WI FSE（TR 2 800ms TE 131ms）0.5T：T1WI SE（TR 500ms,TE 15ms）;T2WI FSE（TR 3 000ms,TE130ms）,层厚5mm,层间距1.0mm。结果 69例Wallerian患者中,Wallerian患者脑损害发生时间与检查时间为5周-3年,其中4-5周2例,5周-12月60例,大于12月7例,异常信号经放射冠、穿过内囊膝部及（或）后肢的前半部、大脑脚外侧及脑桥基底部达延髓锥体,且连续多于3个层面（3个层面以上）可观察到;常规MRI条状异常信号为稍长T1信号,长T2信号2例,T2Flair序列呈斑片状稍高信号;67例条状异常信号为长T1长T2信号,有12例观察到病侧脑干萎缩,以中脑患侧大脑脚萎缩较显著。结论 MRI可明确显示脑损害后锥体束Wallerian变性,有助于临床医师对患者预后正确评估及制定运动功能康复的治疗计划。Objective To explore the value of conventional MRI in the diagnosis of Wallerian degeneration of pyramidal tract after brain damage. Methods 69 patients with Wallerian degeneration of pyramidal tract after brain damage were subjected to MRI. MRI was regularly performed with fast spin echo sequence （FSE conventional transection, sagittal and coronary scanning） by use of the following parameters ： 1.5T ： T1WI FSE （ TR 550 ms TE 15 ms） T2 WI FSE （ TR 2 800 ms TE 131 ms） 0.5T ： T1WI SE（TR 500 ms,TE 15 ms） ;T2WI FSE（TR 3 000 ms, TE 130 ms） , with a layer thick of 5 mm and a layer space of 1.0 era. Results In 69 patients with Wallerian, the time between the brain damage occurrence and inspection ranged from 5 weeks to 3 years, in which 4 -5 weeks were recorded in 2 cases, 5 weeks-12 months in 60 cases, more than 12 months in 7 cases. The abnormal signals via the corona radiate passed through the internal capsule, and （or） the posterior limb of the internal capsule, the lateral sulcus of erus cerebri and basilar part of pons to medullary pyramid and, in addition, those signals more than three layers can be observed. Conventional MRI strip abnormal signal exhibited a little bit long T1 signal, long T2 signal in 2 cases. Patchy T2FLARI sequence exhibited slightly high signal. Abnormal stripe signal for long T1 long T2 signal exhibited in 67 cases. 12 cases were found the lesion side of the brain stem was atrophy, where lateral peduneulus cerebri of midbrain was more remarkable. Conclusion MRI can clearly show the Wallerian degeneration of pyramidal tract after brain damage, which could help clinicians rightly evaluate the prognosis of patients and make treatment plan for the rehabilitation of movement function.

关 键 词：脑损害 锥体束 WALLERIAN变性 磁共振成像 

分 类 号：R742[医药卫生—神经病学与精神病学] R445.1[医药卫生—临床医学]