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非酮症性高血糖偏侧舞蹈症脑部CT及MRI表现

ISSN号：1005-8001
期刊名称：《影像诊断与介入放射学》
时间：0
分类：R587.204[医药卫生—内分泌;医药卫生—临床医学;医药卫生—内科学]
作者机构：[1]广州市增城区人民医院影像科,广东广州511300, [2]广州市增城区人民医院神经内科,广东广州511300, [3]中山大学孙逸仙纪念医院放射科,广东广州510120
相关基金：广州市增城区人民医院青年医学人才培养基金（编号：2015-QN-002）

作者：刘志锋[1], 蔡金辉[1], 刘庆余[3], 黄曦毅[1], 吴小燕[2], 江瑞信[1], 阮耀钦[1], 郭栋华[1]

关键词：非酮症性高血糖, 糖尿病, 偏侧舞蹈症, 体层摄影术, X线计算机, 磁共振成像, Non-ketotic hyperglycemia, Diabetes, Hemichorea, Tomography, X-ray computed, Magnetic resonance imaging

中文摘要：

目的分析非酮症性高血糖偏侧舞蹈症患者脑部CT及MRI影像学特点。方法回顾性分析11例经临床确诊的非酮症性高血糖偏身舞蹈症患者的脑部CT及MRI表现。11例患者均接受至少一次CT及MRI平扫,其中2例行MRI增强检查,4例加做DWI序列,6例加做MRS序列,2例加做DTI序列,3例复查MRI平扫,1例复查CT平扫。结果 9例CT见豆状核和/或尾状核头部片状高密度影,2例CT阴性;T_1WI 9例高信号,2例阴性;DWI 2例高低混杂信号,1例低信号,1例阴性;MRS检查：NAA峰6例均降低,Cho峰6例均升高,NAA/Cr比值6例均降低,Cho/Cr比值6例均升高;DTI 1例显示左侧内囊前肢纤维束受损,FA值减低,1例阴性。结论非酮症性高血糖偏侧舞蹈症脑部CT及MRI均具有特征性影像表现,DWI、MRS及DTI等序列对确定病变性质、评估神经元丢失或损伤、纤维束受损等有价值。

英文摘要：

Objective To analyze the brain CT and MR imaging manifestations of non-ketotic hyperglycemia hemichorea.Methods Eleven patients with clinically-proved non-ketotic hyperglycemia chorea underwent unenhanced CT and MRI（11）,contrast-enhanced MRI（2）, diffusion-weighted MRI（4）, MR spectroscopy（6）, diffusion tensor imaging（2）, follow-up MRI（3） and CT（1）. Results Patchy hyperdense lesions in the basal ganglia were seen on CT and T_1WI of 9 patients, while the other 2 patients had no positive findings on CT and MRI. The lesions were heterogeneous in 2 / 4, hypointense in 1 / 4, and isointense in 1 / 4 patients who underwent diffusion-weighted MRI. MR spectroscopy showed diminished NAA and elevated Cho, NAA / Cr and Cho / Cr in all 6 patients. Diffusion tensor imaging was normal in 1 patient, showed damage in the anterior limb of the left internal capsule fiber bundle with reduced FA in the other patient. Conclusion There are characteristic features on CT, MRI, diffusion-weighted MRI, MR spectroscopy and diffusion tensor imaging for assessment of brain insult in non-ketotic hyperglycemia hemichorea.

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