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MELAS综合征的MRI和ASL及~1H-MRS特征 被引量:10

MRI,ASL and ~1H-MRS features of MELAS syndrome
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摘要 目的 :探讨MRI常规扫描和ASL及~1H-MRS对线粒体脑肌病伴高乳酸血症和脑卒中样发作(Mitochondrial encephalopathy with lactic acidosis and stroke-like episodes,MELAS)综合征的诊断价值。方法 :对9例MELAS综合征患者(男6例,女3例,年龄7~35岁)行头部MR常规轴位、冠状位、矢状位平扫及增强扫描,ASL灌注成像和~1H-MRS检查。结果 :9例患者中2例双侧发病,7例单侧发病。1例累及小脑半球,MRI平扫示顶叶、枕叶、颞叶皮层肿胀,T_1WI呈稍低信号,T_2WI呈稍高信号,FLAIR呈高信号,DWI呈高信号,ADC图呈低信号,增强扫描呈脑回样强化。ASL病变区呈高灌注。~1H-MRS扫描当TE为35 ms时,NAA峰降低,Cho峰略升高,并见Lac双峰,当TE为144 ms时,见倒置Lac双峰。结论 :MELAS综合征的MRI和ASL及~1H-MRS表现具有特征性,MRI和ASL及~1H-MRS对其诊断及鉴别诊断有重要价值。 Objective: To discuss diagnosis value of mitochondrial encephalopathy with lactic acidosis and stroke-like episodes(MELAS) syndrome by MRI routine scan, ASL and 1H-MRS. Methods: A total of 9 patients with MELAS syndrome(6 males, 3 females, age 7-35 years old) were selected. MR routine and enhanced scan, ASL perfusion imaging and 1H-MRS were performed. Results: In 9 cases, 2 cases of bilateral disease, 7 cases of unilateral disease. One case involved the cere- bellar hemisphere. MRI routine scan (parietal lobe, occipital lobe, temporal lobe) cortex were swelling, cortical and subcortical white matter was slightly lower signal on TIWI, brain-like high signal was showed on TtWI of 1 case cortex, T2WI was slight- ly higher signal. FLAIR showed high signal, DWI showed high signal, and ADC map showed hypointensity. Brain-like en- hanced was showed on post contrast images of cerebral cortex. Lesions were significantly higher perfusion on ASL. 1H-MRS: when TE was 35 ms, the NAA peak decreased, Cho peaks raised slightly, and Lac bimodal was showed, when TE was 144 ms, inverted Lac bimodal was observed. Conclusion: MRI routine scan and ASL, 1H-MRS is characterized, MRI and ASL and 1H-MRS is important for diagnose and differential diagnose.
出处 《中国临床医学影像杂志》 CAS 2018年第2期77-79,共3页 Journal of China Clinic Medical Imaging
关键词 MELAS综合征 磁共振成像 MELAS syndrome Magnetic resonance imaging
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