非酮症高血糖性舞蹈病的CT、MRI表现

CT and MRI findings of chorea associated with nonketotic hyperglycemia

目的通过分析非酮症高血糖性舞蹈病的CT和MRI表现与临床表现之间的关系，以探讨该疾病的影像诊断价值。方法回顾性分析6例非酮症高血糖性舞蹈病的影像表现和临床资料。6例均行CT平扫，其中1例行MR扫描。6例中3例行cT复查，1例行MR复查。结果6例患者CT均表现为一侧或两侧纹状体密度增高，均累及壳核，其中5例同时累及苍白球外侧部或尾状核；3例CT复查表现为受累纹状体密度减低或密度增高影消失。1例T1WI表现为两侧豆状核高信号，T2WI表现为低信号；MRI复查示受累豆状核T1WI和T2WI信号无变化。所有患者的舞蹈病症状均在血糖控制后2～6d内消失。

Objective To explore the imaging diagnosis of chorea associated with nonketotie hyperglycemia by describing its CT and MR findings and correlating those findings with the clinical manifestations. Methods The imaging findings and clinical data from 6 patients with chorea associated with nonketotie hyperglycemia were retrospectively analyzed. All 6 patients had unenhaneed CT scans, 1 also had MR imaging examination. Three of 6 patients had follow-up CT scans and 1 of 3 patients had follow-up MR imaging studies. Results CT studies of all 6 patients showed unilateral or bilateral hyperdense striatum. The putamen was involved in all 6 patients, the eaudate nucleus or lateral portion of the globus pallidus were involved in 5 of all 6 patients. All 3 follow-up CT studies depicted a decreased or resolved hyperdensity of the abnormal striatum. T1-weighted MR images in 1 patient showed the hyperintense lesions of bilateral lentiform nuclei, T2-weighted MR images of the patient showed the hypointense lesions of the corresponding lentiform nuclei, and its follow-up MR images depicted invariable signal intensity of T1-weighted and T2-weighted images. In all patients, the chorea resolved within 2 to 6 days after treatment of the hyperglycemia. Conclusion The characteristic imaging findings of chorea associated with nonketotic hyperglycemia can suggest an accurate diagnosis.