基于MRI胼胝体信号及形态判断原发性胼胝体变性类型并预测预后  

Judging type of primary degeneration of corpus callosum based on MRI signals and morphology of corpus callosum and predicting prognosis

作　　者：刘茂森 谭平政[1] 杨晓 段丰[2] 胡兴荣 朱道明 LIU Maosen;TAN Pingzheng;YANG Xiao;DUAN Feng;HU Xingrong;ZHU Daoming(Department of Radiology,Lichuan People's Hospital,Lichuan 445400,China;Department of Neurology,Lichuan People's Hospital,Lichuan 445400,China;Department of Radiology,Central Hospital of Enshi Tujia and Miao Autonomous Prefecture,Enshi 445000,China)

机构地区：[1]利川市人民医院放射科,湖北利川445400 [2]利川市人民医院神经内科,湖北利川445400 [3]恩施土家族苗族自治州中心医院放射科,湖北恩施445000

出　　处：《中国医学影像技术》2023年第11期1630-1634,共5页Chinese Journal of Medical Imaging Technology

基　　金：恩施土家族苗族自治州科技计划研究与开发项目(D20220081)。

摘　　要：目的 探讨基于MRI胼胝体信号及形态判断原发性胼胝体变性[马-比二氏病(MBD)]类型及预测预后的价值。方法 回顾性分析54例急性或亚急性MBD临床及MRI资料,根据MRI所见胼胝体信号及形态将其分为单相型组(n=29)及多相型组(n=25);对患者基线资料、临床表现及MRI所示病变分布和治疗方法进行组间比较,并于症状基本改善或稳定后行改良牛津残障量表(MOHS)评分以评估预后,将出院时MOHS评分≤2归为预后良好,对比组间预后差异。结果 单相型组患者年龄小于多相型组(P<0.01),组间其他一般资料及临床表现差异均无统计学意义(P均>0.05)。54例MRI均见对称性胼胝体及胼胝体外病灶,组间病变分布差异均无统计学意义(P均>0.05)。2组治疗方法差异无统计学意义(P>0.05)。相比多相型组,出院时单相型组MOHS评分及残留神经精神后遗症者占比更低、预后良好者占比更高(P均<0.01)。结论 基于MRI所示胼胝体信号及形态可判断MBD类型并预测预后。Objective To explore the value of judging the type of primary degeneration of corpus callosum(Marchiafava-Bignami disease[MBD])based on MRI signals and morphology of corpus callosum and predicting prognosis.Methods Clinical and MRI data of 54 patients with acute or subacute MBD were retrospectively analyzed.According to MRI signals and morphology of corpus callosum,the patients were divided into monophasic group(n=29)or multiphasic group(n=25).Patients'baseline data,clinical manifestations,lesion distribution on MRI and treatment plans were compared between groups.When the symptoms were basically improved or stabilized,the patients were evaluated with modified Oxford handicap scale(MOHS)score for prediction of prognosis.Those with MOHS score≤2 at discharge were classified as with good prognosis,and patients'prognosis were comparatively analyzed between groups.Results Patients in monophasic group were younger than those in multiphasic group(P<0.01),while no significant difference of clinical manifestations nor other general data was found between groups(all P>0.05).MRI showed revealed symmetric lesions within corpus callosum and extra-callosum in all 54 cases,and no significant difference of lesions distribution was detected,nor of treatment plans between groups(all P>0.05).At discharge,MOHS scores and the proportion of residual neurological and psychiatric sequelae in monophasic group were all lower,while the proportion of good prognosis was higher than those in multiphasic group(all P<0.01).Conclusion The type of MBD judged based on MRI signals and morphology of corpus callosum was helpful to predicting prognosis of MBD patients.

关 键 词：原发性胼胝体变性 磁共振成像 预后 

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]