MELAS综合征的MRI表现及鉴别诊断  

MRI findings and differential diagnosis of MELAS syndrome

作　　者：许凯 张坤 苏航[2] 何荣华 王艳 习羽 张雷[2] 任转勤[2] 金晨望 XU Kai;ZHANG Kun;SU Hang;HE Ronghua;WANG Yan;XI Yu;ZHANG Lei;REN Zhuanqin;JIN Chenwang(Department of Radiology,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China;Department of Radiology,Baoji Central Hospital,Baoji 721008,China)

机构地区：[1]西安交通大学第一附属医院医学影像科,陕西西安710061 [2]宝鸡市中心医院医学影像科,陕西宝鸡721008

出　　处：《实用放射学杂志》2020年第2期194-197,共4页Journal of Practical Radiology

摘　　要：目的 探讨MRI新技术在线粒体脑肌病合并乳酸血症和卒中样发作(MELAS)综合征诊断中的价值.方法 选取近8年进行MRI扫描并通过基因检测确诊的MELAS综合征患者16例,均行头颅MRI平扫,其中DWI扫描12例,MRA扫描9例,MRS扫描4例,三维动脉自旋标记(3D ASL)扫描3例,T1增强扫描2例,分析其MRI影像表现特点.结果 16例中均出现大脑皮质或皮质下长T1、长T2异常信号,12例DWI均呈高或稍高信号,9例MRA中均无明显血管狭窄,其中3例病灶区可见增多的分支血管,4例MRS可见乳酸峰,3例3D ASL示病灶区呈高灌注,2例T1增强扫描可见轻度强化,4例复查时病灶出现游走性.结论 在MELAS综合征的MRI扫描中,DWI、MRA、MRS、3DASL及T1增强扫描均有特征性.Objective To explore the value of MRI new technology for diagnosing mitochondrial encephalomyopathy lactic acidosis stroke like episode(MELAS)syndrome.Methods MRI data of 16 MELAS syndrome patients confirmed by gene detection in recent 8 years were analyzed retrospectively,and MRI features of plain scan(n=16),DWI(n=12),MRA(n=9),MRS(n=4),3D ASL(n=3),T1 contrast-enhanced scan(n=2)were analyzed.Results MRI of all the lesions showed low signal on spin-echo sequence of T1WI,while high signal on T2WI,T2 FLAIR and DWL9 of 16 patients underwent MRA and 3 showed increased arterial branches in lesion zones.Lesions in 4 patients showed increasing Lac peak on MRS.3 patients had 3D ASL scanning demonstrating high irrigation in lesion zones.Linear gyrilike mild enhancement was found in 2 patients with T1 contrast-enhanced scan.Lesion migration occurred in 4 patients during follow-up examination.Conclusion In the MRI scan of MELAS syndrome,DW1,MRA,MRS,3D ASL and T1 contrast-enhanced scan has the characteristics.

关 键 词：MELAS综合征 磁共振成像 鉴别诊断 

分 类 号：R742[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]