磁共振成像表现特征鉴别成人可逆性胼胝体压部病变综合征与胼胝体压部缺血性脑梗死  

Value of Magnetic Resonance Imaging Findings in Differential Diagnosis between the Adult Reversible Splenial Lesion Syndrome and Ischemic Infarction of the Splenium of the Corpus Callosum

作　　者：邢新博[1,2] 习伟[1] 王鑫坤[1] 杨淑辉[1] 聂明明 胡明艳[1] 任敬梅[1] 杨家斐[1] 娄昕[2] XING Xinbo;XI Wei;WANG Xinkun;YANG Shuhui;NIE Mingming;HU Mingyan;REN Jingmei;YANG Jiafei;LOU Xin(Magnetic Resonance Imaging Section,Department of Radiology,the First Affiliated Hospital of Chinese PLA General Hospital,Beijing 100048,China;Department of Radiology,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]中国人民解放军总医院第一附属医院放射科核磁室,北京100048 [2]中国人民解放军总医院放射科,北京100853

出　　处：《中国医学科学院学报》2018年第2期233-241,共9页Acta Academiae Medicinae Sinicae

摘　　要：目的对成人可逆性胼胝体压部病变综合征(RESLES)与缺血性脑梗死的磁共振成像(MRI)表现特征进行对比观察,分析MRI征象在两者疾病鉴别中的作用。方法回顾性分析2015年5月至2017年6月临床诊断为RESLES的7例患者及存在胼胝体压部缺血性梗死的13例患者的临床资料及MRI表现特点,重点对胼胝体压部病变的MRI表现位置、形态、信号强度、最大横截面面积、扩散加权成像(DWI)、表观扩散系数(ADC)值进行分析。结果 7例RESLES患者(男5例、女2例)病变中心部位位于胼胝体压部中线部,呈圆形、椭圆形或梭形,以胼胝体为中心对称分布,DWI均呈现高信号,ADC值减低,最大横截面面积平均为(56.9±32.6)mm^2,ADC值平均为(0.3963±0.0715)×10^(-3)mm^2/s,通过复查(平均10 d),病灶消失;而13例胼胝体压部缺血性脑梗死病灶的患者(男10例、女3例)胼胝体压部病变大多数偏一侧,位于中线部位少见,呈现片状或不规则型,DWI也均为高信号,最大横截面面积平均为(55.1±43.9)mm^2,ADC值平均为(0.4978±0.0123)×10^(-3)mm^2/s。两组最大横截面面积(t=0.096,P=0.925)和ADC值(t=-1.988,P=0.062)差异均无统计学意义。结论对比7例RESLES患者与13例有胼胝体梗死灶患者的MRI特征显示,胼胝体压部病灶的位置、形态以及脑内是否存在其他病灶对两者的鉴别有一定价值。而两者病灶的信号、ADC值及病灶面积无差异,两者的鉴别尚需结合临床特点。Objective To evaluate the magnetic resonance imaging(MRI)findings in differential diagnosis between the adult reversible splenial lesion syndrome(RESLES)and ischemic infarction of the splenium of the corpus callosum(SCC).Methods The MRI findings and clinical data of 7 RESLES patients and 13 patients with ischemic infarction of SCC who were clinically diagnosed and treated in our center from May 2015 to June 2017 were analyzed retrospectively.The main MRI findings included location,morphology,signal intensity,maximum cross-sectional area,diffusion weighted imaging(DWI),and apparent diffusion coefficient(ADC)value.Results On the MRI findings of 7 RESLES patients(5 males and 2 females),the centers of all lesions of the SCC were located in the midline of SCC,the lesion shapes were round,ellipse,or spindle,and the distribution of the lesions was bilateral and symmetric as the center of the midline of SCC.The lesions were hyperintense on DWI,and the mean maximum cross-sectional area of lesions was(56.9±32.6)mm 2 and the mean ADC value was(0.3963±0.0715)×10-3 mm 2/s.On the review MRI,all the lesions disappeared(mean interval:10 days).On the MRI findings of 13 patients with ischemic infarction of SCC(10 males and 3 females),the lesions were irregular or patchy in shape and were almost laterally and asymmetrically distributed.The lesions were hyperintense on DWI,and the mean maximum cross-sectional area was(55.1±43.9)mm 2 and the mean ADC value was(0.4978±0.0123)×10-3 mm 2/s.The mean maximum cross-sectional area(t=0.096,P=0.925)and the ADC value(t=-1.988,P=0.062)were not significantly different between RESLES group and ischemic infarction of SCC group.Conclusions The location,morphology,and distribution of the SCC lesions and the co-existence of other lesions in the brain are helpful for the differential diagnosis between RESLES and ischemic infarction of SCC.However,the mean maximum cross-sectional area and the ADC value show no obvious difference between these two diseases.

关 键 词：磁共振成像表现 可逆性胼胝体压部病变综合征 缺血性脑梗死 

分 类 号：R445.2[医药卫生—影像医学与核医学]