MRI诊断Marchiafava-Bignami病的临床价值分析  

Analysis of the value of MRI in the diagnosis of Marchiafava-Bignami disease

作　　者：裴磊 张发 PEI Lei;ZHANG Fa(Department of Radiology,The Quzhou Affiliated Hospital of Wenzhou Medical University,Quzhou People's Hospital,Quzhou 324000,China;Department of Radiology,The people's Hospital of Liuzhi Region,Liupanshui 553000,China)

机构地区：[1]温州医科大学附属衢州医院,衢州市人民医院放射科,浙江衢州324000 [2]贵州省六枝特区人民医院放射科,贵州六盘水553000

出　　处：《医学影像学杂志》2024年第9期13-15,共3页Journal of Medical Imaging

摘　　要：目的探讨Marchiafava-Bignami病(MBD)MRI检查的应用价值。方法选取MBD患者28例,行MRI检查,分析胼胝体区及胼胝体外病灶的MRI特征。结果28例患者中急性型17例,亚急性型6例,慢性型5例。17例急性型MBD中13例表现为胼胝体肿胀,以胼胝体膝部、体部较为明显,病灶为两侧对称分布,边界不清楚,呈T_(1)WI低信号、T_(2)WI和FLAIR序列高信号。亚急性型MBD中5例表现为胼胝体轻度肿胀,3例正中矢状位可见胼胝体呈“三明治征”改变,即胼胝体中层T_(1)WI低信号、T_(2)WI高信号,上下两层信号相对正常。慢性型MBD中有5例胼胝体体积缩小和轻中度萎缩,病灶边界较清楚。28例患者中有16例表现为DWI序列高信号,ADC值可降低或稍高。28例患者中21例出现胼胝体以外病灶,分布以半卵圆中心和额顶叶脑白质区、前联合、小脑中脚为主,信号改变同胼胝体内病变一致。结论Marchiafava-Bignami病可发生在胼胝体和胼胝体外,病灶大多对称分布,常规MRI结合DWI诊断MBD临床价值高。Objective To investigate the clinical manifestations and MRI imaging features of Marchiafava-Bignami disease(MBD).Methods A retrospective study was conducted on 28 patients diagnosed with MBD,including clinical manifestations and imaging examinations and the morphological distribution characteristics and signal performance of the patients'corpus callosum area and extra-corpus callosum lesions were analyzed.Results Among the 28 patients,17 had acute MBD,6 had subacute MBD,and 5 had chronic MBD.13 of the 17 acute MBD cases showed swelling of the corpus callosum,which was more obvious in the knee and body of the corpus callosum,and the lesions were symmetrically distributed on both sides with unclear borders,showing low signal in T_(1)WI and high signal in T_(2)WI and FLAIR sequences.Five cases of subacute MBD showed mild swelling of the corpus callosum,and three cases showed a"sandwich sign"change of the corpus callosum in the median sagittal view,i.e.low signal in T_(1)WI and high signal in T_(2)WI in the middle layer of the corpus callosum,with relatively normal signal in the upper and lower layers.In the chronic type of MBD,5 cases showed reduced volume and mild to moderate atrophy of the corpus callosum,with clear boundaries.16 of 28 patients showed DWI high signal,while the rest showed slightly high or equal signal,and ADC values could be decreased or increased.21 of 28 patients showed extra-callosal lesions,mainly in the centrum semiovale and frontoparietal white matter,anterior commissure,and mid-cerebellar peduncle,with signal changes consistent with those in the corpus callosum.The signal changes were consistent with the intracallosal lesions.Conclusion MBD can occur in both the corpus callosum and extra-corpus callosum,and the lesions are mostly symmetrically distributed.

关 键 词：胼胝体变性 酒精性脑病 磁共振成像 

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]