橄榄－桥脑－小脑萎缩的临床及磁共振研究

AclinicalandquantitativeanalysisofthemagneticresonanceimaginginOPCA

为定量分析橄榄－桥脑－小脑萎缩（ＯＰＣＡ）磁共振参数及临床特征，用ＭＲＩ对２８例ＯＰＣＡ及４４例血管性头痛和神经症患者进行脑干、小脑的ＭＲＩ直接测量。结果发现，ＯＰＣＡ患者脑干的各径线与对照组相比明显缩短，脑桥与中脑及延髓径线之比虽较对照组减少，但只有脑桥与低位延髓横径之比值与对照组比较有差异；而脑干各径线与第四脑室前后径之比明显减少，与对照组相比差异均有显著意义。２８例中小脑中脚萎缩１８例（６４．３％），颈髓萎缩６例（２１．４％）。ＯＰＣＡ临床以小脑、锥体束或锥体外系症状为三大主要表现，因此说明，ＯＰＣＡ是一种弥漫萎缩性病变。

Inordertoquantitativeanalysisofthemagneticresonanceimaging(MRI)andtomakeaclinicalstudyinolivopontocerebelaratrophy(OPCA),theauthorsusedMRItomeasurebrainstemandcerebelumonmidsagitalT1-weightedimagesin28casesofOPCAand44casesofvas-cularheadacheorneurosis.TheresultsshowedthateachdiameterofthebrainsteminOPCAgroupwasdecreasedthanthatinthecontrolgroup(P<0.05).Theratiosofthediametersofthemensen-cephalon,themedulaoblongatatothediametersoftheponswasdecreasedascomparedtothecon-trolgroup,buttherewasnosignificantdiference(P>0.05),andtheratiosoflowmedulaoblonga-tatotheparametersoftheponswasdecreasedthanthatinthecontrolgroup(P<0.05).Theratiosofthediametersofthefourthventricletoeachparameterofthebrainstemwereobviouslydecreased(P<0.001orP<0.05),andwiththe18cases(64.3%)ofthecerebelarmiddlepeduncleatrophyand6cases(21.4%)ofthespinalcordatropy.Therefore,OPCAwasadiseasewithwideinvolve-mentofthecentralnervesystematrophy.