蜂蛰致中枢神经系统损伤的磁共振表现(附3例报告并文献复习)  

MRI Findings of Central Nervous System Injury After Bee Sting(3 Cases Report and Literature Review)

作　　者：杨淑辉 杨家斐[1] 邢新博[1] 尚柳彤 王鑫坤[1] 胡明艳 YANG Shuhui;YANG Jiafei;XING Xinb(Department of MR,the First Affiliated Hospital of the PLA Hospital,Beijing 100048,P.R.China)

机构地区：[1]解放军总医院第四医学中心磁共振室,北京100048

出　　处：《临床放射学杂志》2020年第1期217-220,共4页Journal of Clinical Radiology

摘　　要：目的探讨蜂蛰伤中枢神经系统损伤的磁共振影像表现及治疗后的影像转归。方法收集3例蜂蛰伤后出现中枢神经系统异常患者的临床及影像资料,3例均行头颅磁共振检查,经治疗后均行磁共振复查。结果2例表现为双侧基底核团对称性病变,在T1WI、T2WI上呈稍高信号,DWI呈高及稍高信号,其中1例合并双侧额顶枕叶皮层层状坏死,T1WI呈条状高信号;1例表现为右侧额顶颞枕叶、基底节区、侧脑室旁、左侧枕顶叶急性期脑梗塞;3例经治疗后临床症状好转,磁共振复查范围均较前减小,T1信号由高到低,T2信号由高到稍高,DWI由高到稍高。结论蜂蛰致中枢神经系统损伤可表现为双侧苍白球纹状体坏死、皮层层状坏死及脑梗塞等,影像表现有一定的特点,及时治疗后病变的MRI影像变化与临床症状好转相符。Objective To investigate the MRI findings of Central Nervous System(CNS)injury after bee sting and imaging outcome after therapy.Methods The clinical and imaging data of 3 patients with central nervous system abnormalities after bee sting were collected.All 3 patients were examined by magnetic resonance imaging of the skull.Results 2 cases involving bilateral basal nuclei showed symmetrical slight hyperintensity on T1WI and T2WI,and hyperintensity on DWI.1 case accompanied with cortical laminar necrosis of bilateral frontal,parietal and occipital lobe,demonstrating linear hyperintensity on T1WI.1 case indicated acute cerebral infarction of right frontal,parietal,temperal and occipital lobe,basal ganglia region,besides lateral ventricle and left occipital and parietal lobe.The clinical symptom of 3 cases improved after therapy.The ranges on MR reexamination were smaller than before,T1WI signal changing from hyerintensity to hypointensity,T1WI and DWI signal changing from hyerintensity to slight hyperintensity.Conclusion CNS injury after bee sting can manifest as pallidostriatal necrosis,cortical laminar necrosis and cerebral infarction,etc.The imaging findings have certain characteristics.The MR imaging changes after timely treatment were consistent with the improvement of clinical symptoms.

关 键 词：蜂蛰伤 中枢神经系统 损伤 磁共振成像 层状坏死 

分 类 号：R646[医药卫生—外科学] R747.9[医药卫生—临床医学] R445.2