Creutzfeldt-Jakob病磁共振弥散加权像与临床表现及脑电图一致性的研究

Consistency study of diffusion-weighted magnetic resonance imaging with clinical features and EEG in Creutzfeldt-Jakob disease

目的探讨散发性Creutzfeldt-Jakob病(CJD)早期、准确诊断的方法,评价磁共振弥散加权像(DWI)在CJD诊断中的地位。方法回顾性比较13例散发性CJD患者DWI异常信号与临床表现及脑电图三相波(PSD)的一致性。结果DWI异常信号与临床表现及脑电图PSD有较高的一致性,并且较临床症状和体征以及PSD表现更早,更敏感;DWI异常信号随病程不断变化,最先表现在大脑皮层区,而后表现在底节区,且底节区异常信号持续时间最长;DWI异常高信号对CJD诊断特异性为81.3%,敏感性为100%,但样本较小。结论临床可疑的CJD患者,头颅DWI检查完全可以作为早期、无创性、准确诊断的重要方法。

Objective To evaluate the value of diffusion-weighted magnetic resonance imaging （DWI） for the early and accurate diagnosis of sporadic Creutzfeldt-Jakob disease （CJD）. Methods DWI abnormalities, clinical features and EEG findings in 13 cases of sporadic CJD were compared. Results There was a strong consistency between DWI abnormalities with clinical features and periodic sharp wave complexes discharge （PSD） in sporadic CJD; DWI abnormalities were more sensitive and early than clinical features and PSD. DWI abnormalities were changing with the progression of the disease; in the early stages, the abnormalities appeared in cortex, then in basal ganglia; in the late stages, the abnormalities disappeared from cortex but still in basal ganglia. The sensitivity of DWI was 100% and specificity 81.3%, but the sample was small. Conclusion DWI examination was useful and reliable for early and accurate diagnosis of sporadic CJD.