目的 探讨MRI T2WI壳核裂隙征以及壳核扩散加权低信号征、脑桥萎缩、桥臂萎缩在诊断P型多系统萎缩(Parkinsonism type of MSA , MSA-P)中的作用。方法 选取2014-09至2019-07就诊于解放军总医院第六医学中心神经疑难疾病会诊中心的86例MSA患者中诊断为MSA-P型的患者20例,并从影像储存与传输系统(picture achiving and communications system, PACS)上选取年龄性别匹配的健康对照组20例。对MSA-P型患者和健康成人的头颅常规MRI扫描序列,包括轴位及矢状位T2加权,轴位T1加权及弥散加权成像序列进行影像学征象分析。对两组患者的脑桥、桥臂萎缩,及壳核扩散加权低信号征,壳核背外侧裂隙征进行评价。结果 20例MSA-P患者中,T2加权像成像裂隙征70%(14/20),壳核扩散加权低信号征90%(18/20);脑桥萎缩30%(6/20),单侧或双侧桥臂萎缩40%(8/20)。MSA-P型患者组的T2加权像成像裂隙征及壳核扩散加权低信号征与健康对照组对比,差异有统计学意义(P<0.01)。结论 MSA-P患者T2加权像成像裂隙征及壳核扩散加权低信号征阳性率明显高于桥臂及脑桥萎缩阳性率,是诊断P型多系统萎缩的主要征象,具有较高的临床诊断价值。
Abstract
Objective To analyze slit-like putaminal hypointensity on T2-weighted imaging, and putaminal hypointensity on DWI,pontine atrophy and middle cerebellar peduncle atrophy in patients with multiple system atrophy-parkinsonian type(MSA-P). Methods Twenty patients with MSA-P and another 20 age-matched healthy subjects were enrolled. The scanning protocol included FSE T2WI sequences on standard sagittal and axial views,T1 FLAIR sequence on the axial view,and diffusion weighted imaging(DWI) sequence on the axial view. Atrophy of the pons and middle cerebellar peduncle,slit-like putaminal hypointensity on T2-weighted imaging,and putaminal hypointensity on DWI were all evaluated. Results Puaminal hypointensity on DWI was observed in 90%(18/20)of the patients,slit-like putaminal hypointensity on T2-weighted imaging in 70% (14/20), unilateral or bilateral middle cerebellar peduncle atrophy in 40%(8/20),and pontine atrophy in 30%(6/20).The slit-like putaminal hypointensity on T2-weighted imaging and putaminal hypointensity on DWI were significantly different between MSA-P patients and controls (P＜0.01). Conclusions The slit-like putaminal hypointensity on T2-weighted imaging and putaminal hypointensity on DWI are more common among MSA-P patients. The incidence of putaminal hypointensity on DWI is higher than that of slit-like putaminal hypointensity on T2-weighted imaging in patients with MSA-P.
关键词
磁共振成像,弥散加权 /
壳核 /
多系统萎缩,帕金森型 /
帕金森病
Key words
magnetic resonance imaging, diffusion weighted /
putaminal /
multiple system atrophy,Parkinsonian type /
Parkinson disease
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