糖尿病纹状体病的临床与影像学分析  

Clinical and imaging analysis of diabetic striatopathy

作　　者：徐元园 高荣基 时强 闫呈新 XU Yuanyuan;GAO Rongji;SHI Qiang;YAN Chengxin(Department of Medical Imaging,the Second Affiliated Hospital of Shandong First Medical University,Tai’an,Shandong Province 271000,China)

机构地区：[1]山东第一医科大学第二附属医院医学影像科,山东泰安271000

出　　处：《实用放射学杂志》2024年第4期519-522,共4页Journal of Practical Radiology

基　　金：山东省老年医学学会科技攻关项目(LKJGG2021W092)。

摘　　要：目的探讨糖尿病纹状体病(DS)的临床表现与影像学特征。方法回顾性分析8例DS患者的临床、实验室及影像学资料并结合相关文献分析总结。结果8例患者随机血糖(8.39~24.80 mmol/L)与糖化血红蛋白(HbA1c)(9.0%~21.50%)升高,1例尿酮体(++),7例尿酮体(-)。7例出现偏侧舞蹈症,1例未见此症状。7例MRI显示单侧纹状体T1WI高信号,8例CT呈等/高密度。经控制血糖及其他相关治疗,2例舞蹈症状消失,5例减轻。结论DS主要发生在血糖控制不良的糖尿病患者中,具有典型的临床表现及神经影像学特征,发生部位仅限于患肢对侧纹状体,密切结合临床、实验室及影像学表现可以避免漏诊或误诊。Objective To investigate the clinical manifestation and imaging features of diabetic striatopathy(DS).Methods A retrospective analysis was conducted on the clinical,laboratory,and imaging data of 8 patients with DS,which was then summarized in conjunction with relevant literature.Results Random blood glucose(8.39-24.80 mmol/L)and glycated hemoglobin(HbA1c)(9.0%-21.50%)were elevated in 8 patients.One case had positive urine ketone bodies(++),while 7 cases had negative urine ketone bodies(-).Hemichorea was present in 7 cases,while 1 case did not exhibit hemichorea.A total of 7 cases showed unilateral striatum T1WI hyperintensity on MRI,and 8 cases showed iso/hyper-density on CT scans.Following blood glucose control and other related treatments,involuntary movement disappeared in 2 cases,and symptoms improved in 5 cases.Conclusion DS mainly occurs in diabetic patients with poorly controlled blood glucose,presenting with typical clinical manifestation and neuroimaging features.It manifests exclusively in the contralateral striatum of the affected limb.The diagnosis should be based on a combination of clinical,laboratory,and imaging findings to prevent missed or misdiagnoses.

关 键 词：糖尿病纹状体病 高血糖 偏侧舞蹈症 计算机体层成像 磁共振成像 

分 类 号：R587.1[医药卫生—内分泌] R742[医药卫生—内科学] R814.42[医药卫生—临床医学] R445.2