摘要
目的探讨多系统萎缩(MSA)的临床与MRI特征及其对临床亚型诊断的意义。方法回顾性分析28例MSA患者的临床及MRI资料。结果橄榄脑桥小脑萎缩(OPCA)以小脑体征(75.0%)突出,MRI表现为脑桥萎缩(91.7%)、小脑蚓部萎缩(91.7%),第四脑室扩大(83.8%),T2WI出现脑桥、小脑对称性高信号(63.6%)及脑桥十字征;纹状体黑质变性(SND)以锥体外系症状(80.0%)明显,MRI改变多位于基底节核团,表现为壳核萎缩(60.0%),T2WI示壳核外侧缘缝隙样高信号(80.0%);ShyDrager综合征(SDS)以自主神经症状(81.8%)为主,出现早且重,MRI未见特异性变化。结论MRI有助于提高MSA及其亚型诊断。脑桥萎缩、T2WI高信号改变,尤其是脑桥十字征的出现有助于OPCA诊断;壳核萎缩与T2WI壳核外侧缘缝隙样高信号改变支持SND诊断。
Objective To explore the clinical and MRI features multiple system atrophy （MSA） and the significance of diagnosing its clinical subtypes. Methods Clinical data and MRI features of 28 patients with MSA were retrospectively analyzed and compared. Results Cerebellar signs （75.0%） were dominant clinic features in olivopontocerebellar atrophy （OPCA）. Brain MRI showed atrophy of pontine （91.7%） and cerebellar vermis （91.7%）, fourth ventricle dilatation （83.8%） and T2WI high intensity in pontocerebellar region （63.6%）. Extrapyramidal signs （80. 0% ） were found in striatonigral degeneration （SND） with apparent basal ganglia changes such as putamen atrophy （60. 0% ） and lineal T2WI high intensity of the lateral margin of the putamen （ putamen slit） （ 80. 0% ）. Shy-Drager syndrom （ SDS ） presented mainly with autonomic nerve system （ 81.8% ） , and autonomic nerve system failures appeared earlier and more severe than the other two subtypes of MSA. Conclusions MRI examination may be useful in diagnosis of MSA and its subtypes. Pontine atrophy, T2WI high intensity, especially pontine cross sign may support diagnosis of OPCA. However, putamen atrophy and putamen slit are the specific imaging signs in SND.
出处
《临床神经病学杂志》
CAS
北大核心
2006年第2期86-89,共4页
Journal of Clinical Neurology
关键词
多系统萎缩
MRI
诊断
multiple system atrophy
MRI
diagnosis
