不同临床类型Marchiafava-Bignami病的MRI表现分析  

Analysis of MRI Findings of Marchiafava-Bignami Disease in Different Clinical Type

作　　者：刘静[1] 高博[2] 余永程[3] 沈桂权[1] 李小宝[1] 余晖[1] LIU Jing GAO Bo YU Yongcheng et al(Department of Radiology, affiliated Hospital of Guizhou Medical University, Guiyang 550004,P. R. Chin)

机构地区：[1]贵州医科大学附属医院影像科,550004 [2]甘肃省人民医院放射科,730030 [3]贵州医科大学第二附属医院神经科

出　　处：《临床放射学杂志》2017年第1期19-23,共5页Journal of Clinical Radiology

基　　金：贵州省科技厅科学基金资助(编号:TN2014-51)

摘　　要：目的探讨不同临床类型Marchiafava-Bignami病(MBD)的MRI表现特点。方法回顾性分析35例MBD患者的临床和MRI资料,依据起病形式分为急性型、亚急性型和慢性型,分析各型MBD患者胼胝体病变、胼胝体以外病变的分布、形态和信号特点。结果急性型14例,亚急性型12例,慢性型9例。急性型8例胼胝体肿胀,3例形态正常,3例轻度萎缩;亚急性型9例胼胝体形态正常,2例肿胀,1例萎缩;慢性型6例胼胝体形态萎缩,3例正常。胼胝体病变左右对称者35例;胼胝体病变呈整体分布33例,局部分布2例;胼胝体上下缘清楚34例,胼胝体上下缘不清楚1例。出现"夹心饼干"征象24例,胼胝体中层坏死囊变19例。35例中34例发现胼胝体以外病灶,双侧病变基本对称,双侧半卵圆中心及额顶叶白质出现病变者34例,前连合、小脑中脚出现病变者分别为13、12例,颞枕叶白质内、皮质内出现病变者各3例。35例患者胼胝体病变于DWI呈高信号或稍高信号。结论MBD的病变可发生于胼胝体和胼胝体外多个部位,多数累及整个胼胝体。急性型MBD以胼胝体肿胀为主,慢性型以胼胝体萎缩为主。胼胝体病变的对称分布、"夹心饼干征"和DWI高信号或稍高信号是MBD的特征性MRI表现。Objective To analyze the MRI findings of Mar-chiafava-Bignami Disease（ MBD） in different clinical types and to improve the knowledge and diagnositic level. Methods The clinical characterisitics and MRI findings,including lesion morphology,distribution,signal in 35 cases of MBD were analyzed retrospectively. Three clinical types were derived according to onset-acute,subacute and chronic. Results There were 14 cases of MBD in the acute onset group,12 cases were in the subacute onset group and 9 cases were in the chronic onset group. The MRI showed corpus callosum swelling（ 8 cases）,normal morphology（ 3 cases） and mild atrophy（ 3 cases） in the acute onset group; normal morphology of the corpus callosum（ 9 cases）,mild swelling（ 2 cases） and atrophy（ 1 cases） in the subacute onset group; corpus callosum atrophy（ 6 cases） and normal morphology（ 3 cases） in the chronic onset group. The lesions of the corpus callosum in 35 cases were symmetrically distributed. The lesions of corpus callosum in 33 cases were whole and 2 cases were partial. The edge of corpus callosum in 34 cases were clear and 1 case was unclear. 24 cases showed sandwich biscuit sign,and 19 cases showed middle cystic necrosis within the corpus callosum. The lesions outside the corpus callosum were found in 34 cases,which were roughly symmetrical. The lesions of the centrum semiovale were the most common,in which 13 cases of the anterior commissure,12 cases of the middle cerebelllar peduncles,3 cases of temporal and occipital white matter,3 cases of the cortex. Conclusion The lesions of MBD could be found in the corpus callosum and outside of corpus callosum. Mild swelling of the corpus callosum are commonly seen in acute onset group and atrophy of the corpus callosum are commonly seen in the chronic onset group. The characteristic MRI findings of MBD patients were symmetrically distributed,sandwich biscuit sign,hyperintensity or slightly hyperintensity of DWI in corpus callosum lesions.

关 键 词：胼胝体变性 MRI 诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学] R744.5[医药卫生—诊断学]