自身免疫性胶质纤维酸性蛋白星形细胞病MRI表现  

MRI and clinical manifestations of autoimmune glial fibrillary acidic protein astrocytopathy

作　　者：马俊楠 姜传武[2] 李厚颖 刘平[3] MA Junnan;JIANG Chuanwu;LI Houying;LIU Ping(Department of Radiology,The Second Hospital of Shandong University,Jinan 250033,China;Department of Radiology,Qingdao Hiser Hospital Affiliated of Qingdao University,Qingdao 266033,China;Department of Radiology,The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250001,China)

机构地区：[1]山东大学第二医院影像科,山东济南250033 [2]青岛大学附属青岛市海慈医院影像科,山东青岛266033 [3]山东中医药大学第二附属医院放射科,山东济南250001

出　　处：《医学影像学杂志》2024年第5期27-30,共4页Journal of Medical Imaging

摘　　要：目的 探讨自身免疫性胶质纤维酸性蛋白星形细胞病(GFAP-A)的影像学特点。方法 选取经临床证实的5例自身免疫性GFAP-A患者的MRI表现并进行文献复习。结果 5例患者中4例行颅脑MRI平扫及增强扫描,4例行颈胸腰髓MRI平扫及增强扫描,1例行颈胸腰髓MRI平扫。2例患者颅脑MRI显示病变位于小脑半球、侧脑室旁白质,注射对比剂后,显示小脑半球放射状线样强化,侧脑室旁白质内垂直于侧脑室的线样强化;1例患者颅脑MRI强化图像可见颞叶、枕叶软脑膜线样强化。2例颅脑MRI平扫及增强未见异常。5例患者脊髓MRI显示病变累及脊髓,T2WI表现为斑片状高信号。注射对比剂后病变呈轻度强化。结论 GFAP-A临床少见,症状缺乏特异性,MRI检查具有较大的临床应用价值,结合实验室检查,可提高诊断准确率,避免误诊。Objective To investigate the imaging characteristics and clinical diagnosis of autoimmune glial fibrillary acidic proteinastrocytopathy(GFAP-A).Methods The magnetic resonance(MR)images of 5 patients with clinically confirmed GFAPA were retrospectivelyanalyzed,and literatures were reviewed.Results Among the 5 patients,4 underwent cranial MR plain scan and enhanced scan,4 underwent spinalMR plain scan and enhanced scan,and 1 underwent spinal MR plain scan.In the 5 cases of GFAP-A,the brain MR image lesions mainly located in the cerebellum and periventricular white matter.After contrastin⁃jection,the MR images showed that the lesions were radial lineargadolinium enhancement in the cerebellum and linear gadolini⁃umenhancement in the white matter perpendicular to the ventricle in 2patients.Spine MRI images revealed longitudinally exten⁃sive spinalcord lesions.The lesions showed hyperintensity on T2WI.On enhanced scan,the lesions were slightly enhanced.Conclusion GFAP-A is relatively rare.Clinical manifestations are lack of specificity.MR examination has great clinical value.Combined with laboratory examination can improve the diagnostic accuracy and avoid misdiagnosis.

关 键 词：自身免疫性胶质纤维酸性蛋白星形细胞病 磁共振成像 诊断 

分 类 号：R593[医药卫生—内科学] R445.2[医药卫生—临床医学]