格林巴利【GBS(转)】.doc

《格林巴利【GBS(转)】.doc》由会员上传分享，免费在线阅读，更多相关内容在行业资料-天天文库。

1、格林巴利综合征(Guillain-Barresyndrome)MRI病例图片影像诊断分析 【临床病史】：患者，10岁男孩，近期病毒感染，出现下肢麻痹和反射减弱。CSF检查提示蛋白含量增高，不伴有脑脊液细胞增多。10-year-oldmalewithrecentviralinfectionisadmittedwithlowerextremityparalysisandhyporeflexia.CSFfindingsrevealelevatedproteinlevelwithoutpleocytosis.zz7影像园XCTMR.com【影像图片】MRI图像zz7影像园X

2、CTMR.com  zz7影像园XCTMR.comzz7影像园XCTMR.com【影像表现】：Figure1,Figure2,Figure3andFigure4:Whencomparedwithpre-contrastT1weightedsagittalimages(Figure3),post-gadoliniumsagittalT1-weightedimagesdemonstrateenhancementandthickeningofthecaudaequina(Figure4).对比平扫T1和增强矢状位T1显示马尾增厚强化。zz7影像园XCTMR.com【影像诊

3、断】：Guillain-Barresyndrome格林巴利综合征zz7影像园XCTMR.comDifferentialdiagnosisofabnormalintrathecalnerverootenhancementincludes:异常的鞘内神经根强化鉴别诊断包括：1.AIDS-relatedpolyradiculopathyAIDS相关的多发性神经根病；2.Arachnoiditis蛛网膜炎；3.Sarcoidosis结节病；4.Metastaticdisease转移性病变。zz7影像园XCTMR.com【诊断要点】：zz7影像园XCTMR.comGuilla

4、inBarresyndromeisaheterogeneousgroupingofimmune-mediatedprocessesgenerallycharacterizedbymotor,sensory,andautonomicdysfunction.Classically,GBSisanacuteinflammatorydemyelinatingpolyneuropathycharacterizedbyprogressivesymmetricascendingmuscleweakness,paralysis,andhyporeflexiawithorwithou

5、tsensoryorautonomicsymptoms;however,variantsinvolvingthecranialnervesorpuremotorinvolvementarenotuncommon. 格林巴利综合征是一种免疫介导的多类型病变，一般特征为运动、感觉及自主功能障碍。典型的情况下，GBS是一种急性炎症性脱髓鞘性多发性神经病，表现为急性进行性对称的逐步向上延伸的肌无力、瘫痪和反射减弱，伴有或不伴有感觉或自主功能障碍。然而其他类型-颅神经或单纯的运动神经受累并非罕见。zz7影像园XCTMR.com   MRIofthethoracolumbars

6、pineisperformedincasesofequivocalCSFandEEGfindingsoratypicalclinicalpresentation. MRIfindingsincludeabnormalthickeningandenhancementoftheintrathecalnerverootsandcaudaequina. TheenhancementofonlyanteriorspinalnerverootsisstronglysuggestiveofGuillainBarresyndrome.MRIisasensitivebutnon-sp

7、ecificexamination.当CSF和EEG检查疑诊或临床症状不典型时需要行胸腰椎MR扫描。MRI表现包括异常增粗强化的鞘内神经根和马尾。仅仅是前方的神经根强化强烈的提示GBS。MRI是一种敏感但并不特异的检查。【讨论】：GuillainBarresyndrome(GBS)isanacuteinflammatorydemyelinatingpolyneuropathy(AIDP).Itisanautoimmunediseaseaffectingtheperipheralnervoussystem,usuallytriggeredbyanacuteinfe