肝豆状核变性脑磁共振成像及氢质子磁共振波谱表现  

Liver degeneration of brain magnetic resonance imaging and hydrogen proton magnetic resonance spectroscopy

作　　者：侯效芳 臧晨 苗园园 赵晶晶 王凤娟[2] Hou Xiaofang;Zang Chen;Miao Yuanyuan;Zhao Jingjing;Wang Fengjuan(Department of Radiology,the Second People′s Hospital of Zhumadian,Henan 463000,China)

机构地区：[1]河南省驻马店市第二人民医院放射科,463000 [2]河南省郑州市第二人民医院影像科

出　　处：《实用医技杂志》2021年第1期5-8,共4页Journal of Practical Medical Techniques

摘　　要：目的探讨肝豆状核变性脑磁共振成像(MRI)及磁共振氢质子波谱(1H-MRS)表现特点,为早期诊断和治疗提供依据。方法回顾性分析经临床和实验室证实26例肝豆状核变性患者的脑部MRI及9例患者的1H-MRS表现,其中,男性17例,女性9例,年龄6~44岁;所有患者均行头颅MRI平扫检查;9例患者行1H-MRS检查。结果26例患者脑部MRI检查,呈长T_(1)长T_(2)信号22例,稍短T_(1)短T_(2)信号1例,混杂长T_(1)混杂长T_(2)信号3例,病灶典型者依受累部位不同,分别表现为“八字”征、“展翅蝴蝶”征;病灶位于豆状核26例,尾状核16例,丘脑12例,中脑9例,桥脑5例,齿状核4例,额叶白质区2例,颞叶1例,12例患者有不同程度的脑萎缩;9例患者行1H-MRS分析,选取38个体素,18个体素置于双侧豆状核,6个体素置于尾状核头部,9个体素置于丘脑,3个体素置于桥脑,2个体素置于额叶。其中22个体素胆碱化合物(Cho)升高,17个体素肌酸(Cr)下降,20个体素区N-乙酰天门冬氨酸(NAA)下降。结论肝豆状核变性的MRI及1H-MRS表现具有一定的特征性,MRI及1H-MRS对肝豆状核变性早期诊断及治疗提供有力依据,并了解不同病程时期,指导临床治疗,评价其治疗效果均有独特的临床作用。Objective To study the liver lentiform nucleus change disease brain magnetic resonance imaging(MRI)and hydrogen proton magnetic resonance spectroscopy(^(1)H-MRS)performance characteristic,and provide the basis for early diagnosis and treatment.Methods A retrospective analysis of 26 cases confirmed by clinical and laboratory liver degeneration in patients with brain MRI and^(1)H-MRS performance,among them,17 cases of male,female 9 cases,age 6 to 44 years old;All patients were performed cranial MRI scan check;9 cases of patients with^(1)H-MRS examination.Results Twenty six patients underwent MRI of the brain,has long T_(1)long T_(2)signal of 22 cases,short short T_(1)T_(2)signal in 1 case,hybrid long T_(1)long T_(2)signal in 3 case of hybrid,lesions in affected areas is different,the typical performance respectively for"eight"sign,"the butterfly wings";Lesions located in lentiform nucleus 26 cases,the caudate nuclei in 16 cases,12 cases of the thalamus,midbrain in 9 cases,5 cases,brain bridge dentate nucleus in 4cases,the frontal white matter area in 2 cases,bilateral temporal lobe in 1 case,12 patients had different degrees of brain atrophy;9 patients line^(1)H-MRS analysis,Choose 38 individual element,18 individual element in bilateral lentiform nucleus,6 individual element in the caudate nucleus in the head,9 individuals in the thalamus,3 the individual element at bridge head,2 individual element in the frontal lobe.22 individual element choline(Cho),17 individual element creatinine(Cr),N-Acetyl-L-aspartic acid(NAA)drop 20 individual element area.Conclusion MRI and^(1)H-MRS of Wilson′s disease have certain char-acteristics,MRI and^(1)H-MRS can provide strong basis for early diagnosis and treatment of Wilson′s disease,and under-stand different stages of disease,guide clinical treatment,evaluation of its therapeutic effect has a unique clinical role.

关 键 词：肝豆状核变性 颅脑照射 磁共振成像 磁共振波谱成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R742.4[医药卫生—诊断学]