CT和MRI对不典型非酮症高血糖性偏侧舞蹈症的诊断价值  

The value of CT and MRI in the diagnosis of atypical hemichorea associated with nonketotic hyperglycemia

作　　者：张效杰 刘华富 张杰 卜庆丰 阎光辉 ZHANG Xiaojie;LIU Huafu;ZHANG Jie;BU Qingfeng;YAN Guanghui(Department of Radiology,Yangchun People's Hospital,Yangjiang,Guangdong 529600,China)

机构地区：[1]阳春市人民医院影像科,广东阳江529600

出　　处：《影像研究与医学应用》2023年第15期8-10,14,共4页Journal of Imaging Research and Medical Applications

基　　金：阳江市医疗卫生科技计划项目(SF2022044)。

摘　　要：目的:掌握不典型非酮症高血糖性偏侧舞蹈症(HC-NH)的临床和影像表现,分析CT和MRI对本病的诊断价值。方法:选取2015年1月—2022年12月阳春市人民医院诊治的具有脑基底节CT高密度及MRI T1WI高信号的病例27例,总结其临床及影像资料,分析CT和MRI诊断不典型HC-NH的效能。结果:患者就诊时均无舞蹈症,主要症状或体征包括头晕、呕吐、言语不清、意识模糊、肢体乏力等。其中23例入院时行CT平扫检查,26例行MRI平扫及弥散加权成像(DWI)检查,包括3例MRI增强扫描,3例磁敏感加权成像(SWI)扫描。以临床表现及实验室检查为金标准,共确诊不典型HC-NH 13例。CT、MRI及CT联合MRI诊断本病的灵敏度、特异度及准确率分别为[72.7%(8/11)、 100.0%(12/12)、 87.0%(20/23)],[83.3%(10/12)、85.7%(12/14)、84.6%(22/26)],[90.0%(9/10)、 100.0%(12/12)、95.5%(21/22)]。结论:临床症状不典型的HC-NH可出现特征性影像学表现,CT、MRI或二者联合对本病均有重要的诊断提示价值。Objective To master the clinical and imaging features of atypical non ketotic hyperglycemia hemichorea(HC-NH)and recognize the diagnostic value of CT and MRI in this disease.Methods 27 cases with high density CT and high signal MRI T1WI in the basal ganglia diagnosed and treated at Yangchun People's Hospital from January 2015 to December 2022 were selected.The clinical and imaging data were summarized,and the diagnostic efficacy of CT and MRI in atypical HC-NH was analyzed.Results The main symptoms or signs included dizziness,vomiting,slurred speech,confusion,and limb weakness.None of them had chorea at the time of presentation.Among them,23 cases underwent CT scan,26 cases underwent MRI scan and diffusion weighted imaging(DWI)examination,including 3 cases of MRI enhanced scan and 3 cases of susceptibility weighted imaging(SWI)scan.A total of 13 cases of atypical HC-NH were confirmed by clinical and laboratory tests.The sensitivity,specificity and accuracy of CT,MRI and CT combined with MRI in the diagnosis of this disease were respectively[72.7%(8/11),100%(12/12),87.0%(20/23)],[83.3%(10/12),85.7%(12/14),84.6%(22/26)],[90%(9/10),100%(12/12),95.5%(21/22)].Conclusion The HC-NH with atypical clinical symptoms may show characteristic imaging findings.CT,MRI or the combination of them all have important diagnostic value in this disease.

关 键 词：非典型 非酮症高血糖 偏侧舞蹈症 计算机断层扫描 磁共振成像 

分 类 号：R445[医药卫生—影像医学与核医学]