基底节区异常信号的MRI鉴别诊断及临床价值

MRI differentiating diangnosis and clinical value of abnormal signals in basal ganglion

目的:探讨以基底节区异常信号为主要表现的疾病的MRI征象及鉴别诊断价值。方法:回顾性分析22例经临床证实的以基底节区异常信号为主要表现的疾病的MRI资料。结果:发生部位:苍白球9例,壳核17例,尾状核头部12例,合并双侧丘脑4例、脑干6例。肝豆状核变性4例;感染3例;中毒7例,其中CO中毒5例,霉变甘蔗中毒1例,糖尿病药物诱发的乳酸中毒1例;维生素B1缺乏性脑病1例;缺氧缺血损害7例,其中脑梗死4例,HIE 3例。信号特征:肝豆状核变性MRIT1WI等或稍低信号,T2WI高信号;感染、维生素B1缺乏性脑病、脑梗死、新生儿缺氧缺血性脑病,T1WI呈低信号,T2WI呈高信号;CO中毒4例及霉变甘蔗中毒1例表现为T1WI等、低信号,T2WI均为高信号,CO中毒1例及糖尿病药物诱发的乳酸中毒1例,表现为T1WI高信号,T2WI等信号;5例增强后病灶均有明显强化。脑梗死为非对称性分布,其余皆为对称性分布。结论:以基底节区异常信号为主要表现的疾病的MRI有一定的特征性,结合临床不难鉴别。

Objective：To study MRI feature and clinical diangnostic value of abnormal signals in basal ganglion. Methods： MRI features of 22 patients clinically proved were retrospectively analyzed. Results： Nine cases happened in globus pallidus, 17 cases in putamen, 12 cases in head of eaudate nuelus, and 4 cases with both-side of thalamus involved, 6 cases with brain trunk involved; of all the eases,4 cases were hepatolentieular degeneration, 3 cases were infection, 5 cases were CO poisoning, 1 case was moldy sugar cane poisoning, 1 case was lactic acid poisoning induced by diabetes drug,1 case was brain disease lacking of vitamin Bl ,4 cases were infarction in brain, 3 cases were HIE. Singals features： middle or slightly low signal intensity in Tl WI and high signal intensity in T2 WI were found in hepatolentieular degeneration;low signal intensity in Tl WI and high signal intensity in T2 WI were found in infection,brain disease lacking of vitamin Bl , infarction,and HIE. Middle or low signal intensity in Tl WI and high signal intensity in T2 WI were found in 4 cases of CO poisoning and 1 case of moldy sugar cane poisoning; high signal intensity in T1 WI and middle signal intensity in T2 WI were found in 1 case of CO poisoning and 1 case of lactic acid poisoning induced by diabetes drug;signal intensity in 5 cases were obviously enhanced. Only signal of infarction in all the cases was unsymmetrical. Conclusion： Diseases mainly showing abnormal signals in basal ganglion have features, differentiating diagnosis is not hard combining clinical manifestations.