目的探讨肥大性下橄榄核变性(hypertrophic olivary degeneration, HOD)的MRI信号及大小改变特征,以提高对该病的认识和诊断。方法收集继发于脑桥、小脑病变的HOD病例27例,原发病变位于脑桥25例,其中海绵状血管瘤1例,挫裂伤8例,高血压性出血14例,梗死2例;原发病变位于小脑2例,其中小脑挫裂伤1例,小脑出血1例。所有病例均行T₁WI、T₂WI、FLAIR、DWI,8例行SWI检查,分析HOD的信号特点,测量下橄榄核径线。结果MRI表现为下橄榄核体积增大,T₂WI均呈高信号,14例DWI序列呈等信号,13例DWI序列呈稍高信号,所有病例FLAIR呈稍高信号,10例T₁WI呈等信号,17例T₁WI呈稍低信号。病变下橄榄核平均横径为(6.94±0.67)mm,平均前后径为(6.69±0.83)mm,平均纵径为(16.95±1.20)mm,下橄榄核前缘与延髓前缘平均间距为(1.37±0.56)mm。结论MRI能清晰显示下橄榄核肥大变性,正确认识该病,可避免漏诊及误诊。

Objective To study MRI signal characteristics and size change in hypertrophic olivary degeneration(HOD) and improve the diagnosis of this disease. Methods Twenty-seven patients with HOD secondary to pons or cerebellar lesions were studied retrospectively. There were 25 cases with primary lesions located in pons, including cavernomas(1 case), trauma(8 cases), hypertensive hemorrhage(14 cases), and infarction(2 cases). The other 2 cases were with primary cerebellar lesions including trauma(1 case) and hemorrhage(1 case). Plain MRI scans were performed for all cases with T₁WI, T₂WI, FLAIR, DWI sequence and 8 cases with SWI sequence additionally.MRI characteristics of HOD and the diameters of the affected olivary nucleus were observed. Results MRI scan revesled hyperophied olivary nucleus with increased T2WI signal, iso-or slightly high signal intensity on DWI, slightly high intensity on FLAIR, iso-or slightly low signal intensity on T₁WI. The average transverse diameter of the olivary nucleus was(6.94?0.67)mm, the average anterior posterior diameter was(6.69?0.83)mm, the average vertical diameter was (16.95?1.20)mm, the average distance between anterior olivary nucleus margin and medulla anterior margin was(1.37?0.56)mm. Conclusions MRI can clearly demonstrate hypertrophic olivary degeneration, thus avoiding error or mistake.