额顶叶病变不同疾病的影像学表现与临床分析  

Imaging manifestations and clinical analysis of 4 cases of parietal lobe lesions

作　　者：张新奇 贺爽 张弥兰 刘慧勤 黄月 张杰文 

机构地区：[1]郑州大学人民医院神经内科,郑州450000

出　　处：《医药论坛杂志》2017年第12期46-48,52,共4页Journal of Medical Forum

摘　　要：目的探讨颅内病变部位基本相同但不同疾病,如脑出血,脑囊虫、脑囊肿和急性出血性白质脑炎(AHLE)的临床表现及MRI特征,以提高鉴别诊断水平。方法收集郑州大学人民医院神经内科自2016年10月至2017年4月期间的4例MRI表现为额叶病变的患者临床资料,分析其临床表现及影像学特征。结果脑出血患者和AHLE患者首发症状为精神行为异常,脑囊虫患者和脑脓肿患者首发为间断发作性抽搐。脑出血患者MRI表现为长T1稍长T2信号影,FLAIR为低信号,DWI呈高信号。AHLE患者MRI表现为片状短T1短T2信号影,SWI呈低信号,脑囊虫患者MRI表现为长T1长T2信号影,内侧可见小结节状稍短T1稍短T2信号影,DWI呈低信号,增强扫描呈明显环形强化,内侧结节明显强化,周围可见大片状水肿区。脑脓肿MRI表现为片状长T1、T2信号影,FLAIR呈低信号,DWI呈点条状高信号,周围可见水肿信号影。结论上述疾病引起的颅内病变部位基本相同,但MRI影像表现各有特点,诊断中要综合分析,结合临床资料,加强临床及影像学方面的知识,早期识别,早期治疗。Objective To explore the areaof intracranial lesions are basically the same but different diseases,such as cerebral hemorrhage,cerebral cysticercosis,cerebral cyst and acute hemorrhagic white matter encephalitis（ AHLE）clinical manifestations and MRI features. To improve the level of differential diagnosis. Methods The clinical data of 4 patients with frontal lobe lesions from October 2016 to April 2017 were collected from Department of Neurology,People’s Hospital of Zhengzhou University,analysis of its clinical manifestations and imaging features. Results Cerebral hemorrhage patients and AHLE patients with the first symptoms of mental disorders,cysticercosis patients and brain abscess patients with episodes of intermittent seizures. Cerebral hemorrhage patients and AHLE patients with the first symptoms of mental disorders,cysticercosis patients and brain abscess patients with episodes of intermittent seizures. Cerebral hemorrhage in patients with MRI showed long T1 slightly longer signal,FLAIR for the low signal,DWI was high signal.AHLE patients with MRI showed short T1 short T2 signal shadow,SWI showed low signal,MRI showed long T1 long T2 signal shadow,the inside of the small nodules can be seen slightly shorter T1 slightly T2 signal shadow,DWI showed low signal,enhanced scan showed significant ring enhancement,medial nodules were significantly enhanced,surrounded by large flake Edema area. Brain abscess MRI showed flaky long T1,T2 signal shadow,FLAIR showed low signal,DWI was punctate high signal,visible around the edema signal shadow. Conclusion The above-mentioned diseases caused by intracranial lesions are basically the same,but the performance of MRI images have their own characteristics,the diagnosis should be comprehensive analysis,combined with clinical data to strengthen the clinical and imaging knowledge,early identification,early treatment.

关 键 词：额叶 MRI 脑囊虫 脑囊肿 AHLE 脑出血 

分 类 号：R445[医药卫生—影像医学与核医学]