皮质下动脉硬化性脑病的CT特征与临床表现(附36例分析)

CT features and clinic manifestations of subcortical arteriosclerotic encephalopathy: A preliminary analysis of 36 cases

目的 了解皮质下动脉硬化性脑病（ＳＡＥ）在中老年知识分子人群中的发生率、ＣＴ特征及临床表现，从而进一步为诊断提供依据。方法 对８２６名中老年知识分子体检中发现的３６例ＳＡＥ（男２９例，女７例；年龄５２～７８岁）回顾性分析了其ＣＴ特征与临床表现。结果 研究表明，本组人群中ＳＡＥ的发生率近于４．４％。ＣＴ平扫显示双侧脑室旁白质区较对称性低密度影，病变边缘模糊，基底节与内囊等处伴有腔隙性梗塞。桥脑基底部也有稍低密度影，边缘模糊。主要临床表现为头痛、头晕，记忆力减退，高血压，以及高血脂见于全部病例，糖尿病见于１９例，精神异常见于１３例，以及嗜睡状态见于９例。结论ＳＡＥ在中老年知识分子人群中的发生率有待在更大人群中做进一步调查。ＳＡＥ基于上述ＣＴ特征和临床表现不难做出确诊。

Objective To understand the incidence, CT features and clinical manifestations of subcortical arteriosclerotic en- cephalopathy(SAE), so as to provide more evidences for the diagnosis. Methods The incidence of SAE was investigated in the physical examination of 826 middle - old aged knowledgeable population by routine CT plain scan of the head. Then, CT features and clinic mani- festations in 36 patients with SAE which were found from The physical examination (male 29 female 7; aged 52 - 78years) were analyzed retrospectively. Results The incidence of SAE in this study was nenrly 4.4% (36/826). CT plain scan shown that there were symmetrical hypodense shadows with poorly - defined border in the region of bilateral para - ventricular white matter and cavernous lesions of infarction in the internal capsule and basal ganglia region. There were also slightly hypodense shadow with hazy border in the basal part of the pons. Main clinic manifestations of patients with SAE included headache. dizziness, decreasing remembrance, hypertension and hyper- lipoidemia presented in all patients, diabetes mellitus presented in 19 patients, psychic abnormality presented in 13 patients, and lethargy presented in 9 patients. Conclusion The incidence of SAE in middle - old aged knowledgeable population needs more careful investigation in greater population. Based on CT features and clinic manifestations as mentioned above, it is not diffcult to diagnose accurately SAE.