低血糖脑病胼胝体压部MR扩散加权成像高信号的可逆性.pdf

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1、中国学影像学杂志ChineseJournalofMedicalImaging·495中枢神经影像学NeuroimagingDoi：10．3969~．issn．1005—5185．2014．07．004论著OriginalResearch【摘要】目的采用MR扩散加权成像(DWI)评价低血糖脑病(HE)患者恢复血谭红艳．vHongyan糖前后胼胝体压部DWI高信号区表观扩散系数(ADC)的变化，探讨本病DWI征张健ZHANGJian象的可逆性。资料与方法回顾性分析临床确诊的35例HE患者，MR显示胼胝体压部DWI高

2、信号并经及时治疗后病灶消失，记录患者的低血糖持续时问(发病至刘君凤。LIUJunfengm糖恢复正常的时『HJ)和恢复时间(血糖恢复正常至患者临床症状恢复至发病前的计学文’JlXuewen时间)，并分别测量首次DWI检查高信号区的ADC值，以病灶外正常白质区ADC张炬赫zHANGXuanhe值作为对照，汁算ADC值平均降低百分比(ADCm—ADC／ADC)。吴佳芮WU3tarui结果35例HE患者低血糖持续时间<24h，恢复时间4～72h。MR图像显示痫宋博soNGBo灶均局限性位于胼胝体中线处，未累及胼胝体全

3、部，T1wI呈等信号，T2W1呈等或稍高信号，DWI呈明显高信号、ADC值下降。病灶DwI高信号区ADC值为(0．28±0．06)×l0mm／s，显著低于对照区的(0．88±0．13)×10mm2／s(P<0．05)，ADC作者单位值平均降低(67．05±7．40)％。患者血糖恢复后胼胝体压部高信号消失、发生可逆性改变，1．佳木斯市中心医院MR室黑龙江佳木斯病变区ADC值恢复正常。结论胼胝体压部是HE可逆性损伤的最好发部位，DWIl54002序列ADC值测量可以准确地评价HE损伤是否可逆，对临床治疗及预后判断具

4、有最要指导意义。2．佳木斯大学附属第一医院MR室黑龙江佳木斯l54002【关键词】脑疾病；低m糖症：胼胝体：磁共振成像，弥散：扩散加权成像；表观扩散3．佳木斯市中心医院CT室黑龙江佳木斯系数154002[Abslraet]Purpo~MRdifusionweightedimaging(DwI1isusedtoinvestigatethechangesofapparentdifusioncoefficient(ADC)inhighsignalareaofthespleniumofthecorpuscallosum

5、onDWIbeforeandafterrestorationofbloodglucoseinpatientswithhypoglycemicencephalopathy通讯作者张健(HE)toexplorethereversibilityofDWIsignsofthisdisease．MaterialsandMethodsThir-fiveHEpatientswithclinicallyconfirmedwereretrospectivelyanalyzed．MRshowedthattheDWIhighDepa

6、rtmentofMRJiamusiUniversityNo．1signallesionsinspleniumofthecorpuscallosumdisappearedaftertimely~eatment，hypoglycemiaduration(thetimedurationfromonsettobloodglucosebacktonorma1)andtheirl~'coverytime(theHospital，Jiamusi154002，Chinatimedurationfrombloodglucoser

7、eturnedtonormaltoclinica1symptomsbacktothestatebeforeonset)wererecorded．ADCvalueofhighsignalareainthefirstDWIscanwasalsomeasuredwiththeADCvalueofnormalwhitematteroutsidethelesionsasacontro1．thedifferencesofADCvalueAddressCo~espondencetO：ZHANGdianwerecalculat

8、edfADCvalueofcontrolregionminusADCvalueofthe1esiondividedADCvalueofE-mail：zhangjiangyw@163．comcon~o1region)．ResultsHEdurationofthe35casesofhypoglycemiainpatientswaslessthan24hours．andtherecovery