胼胝体变性的CT和MRI分析

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1、临床放射学杂志1999年第18卷第8期·453·ü中枢神经放射学þ胼胝体变性的CT和MRI分析高勇安张念察李坤成张轶群张通摘要目的:分析胼胝体变性的CT和MRI征象。材料与方法:4例胼胝体变性中,3例为急性发病,1例呈慢性过程。4例均行头颅CT扫描,2例行MRI检查,其中1例同时行MRI增强扫描。结果:2例CT示胼胝体膝部和压部呈片状低密度病变,2例病变仅见于膝部。病变的膝部(3例)和压部(2例)呈膨胀性改变,其中1例发病16天后,MRI平扫和强化未见膨胀性改变和异常强化。结论:(1)CT和MRI是诊断胼胝体变性的有效方法,

2、MRI显示胼胝体更全面准确,特别是体部的显示;(2)胼胝体变性CT主要表现是片状低密度灶,急性发病者以膝部和压部常见,可见膨胀性改变,以膝部尤著;(3)晚期胼胝体病变区萎缩,MRI表现为胼胝体中层带状低信号(T1WI),无强化。关键词胼胝体变性CTMRIMarchiafava-BignamiDisease:AnalysisofCTandMRIFindingsGaoYongan,ZhangNiancha,LiKuncheng,etal.DepartmentofRadiology,XuanwuHospital,CapitalUn

3、iversityofMedicalSciences,Beijing100053,P.R.ChinaABSTRACTObjective:ToanalyzetheCTandMRIfindingsofMarchiafava2Bignamidisease.MaterialsandMethods:Theclinicalfeaturesof4cases(3acuteformand1chronicform)werecorrelatedwiththefindingsonCT(n=4)andMRI(n=2).Results:CTreveale

4、dalargelow2densityareaingenuandsplenium(n=2)oringenuonly(n=2).Expansionoftheaffectedgenu(n=3)andsplenium(n=2)wasobservedintheearlystage.Theenlargementandabnormalenhancementofgenuinonepatientcouldnotdemonstratedonbothplainandcontrast2enhancedMRIperformed16daysaftero

5、nset.Conclusion:(1)BothCTandMRIareeffec2tivemodalitiesfordiagnosingMarchiafava2Bignamidisease.MRIshowsthecorpuscallosum,especiallyitsbody,moreclearly.(2)ThemainfeatureofMarchiafava2BignamidiseaseonCTisalow2densityarea.Inacuteform,enlargementofthesplenium,andparticu

6、larlyofthegenu,iscommonlyseen.(3)Inthelatestage,thelesionbecomesatrophied,andabnormalband2shapedlowsignalzonewithoutenhancementisseeninthemiddlelayerofcorpuscallosumonT1WI.KeywordsMarchiafava2BignamidiseaseCTMRICorpuscallosumdemyelination胼胝体变性(corpuscallosumdemyeli

7、nation),又0T全身磁共振成像仪,采用常规SE序列行头颅MRI称Marchiafava2Bignamidisease,较少见。国内外文献检查,T1WI:TR450ms,TE15ms;T2WI:TR4000ms,[1～6]仅见少数个案报道。本文总结4例经我院诊治的胼TE90ms,层厚6mm,间隔1.5mm。[7]胝体变性病例(1例曾作报道),着重分析其CT和MRI表现,旨在提高对这类病变的认识和诊断水平。2结果2例CT显示胼胝体膝部和压部片状低密度;膝部1材料与方法低密度不均匀,以两侧病变较重,病灶边缘模糊,病变4例均为

8、男性,年龄37～57岁。3例呈急性发病过的膝部和压部呈膨胀性改变,以膝部为著,使双侧脑室程,表现为发作性四肢抽搐,2例伴有意识障碍。1例呈前角变窄,压部低密度病灶较均一(图1、2)。2例CT仅慢性发病过程,表现为渐进性双下肢无力,言语不清,见胼胝体膝部低密度灶,病变密度较均匀,压部未见异记