肝移植术后桥脑中央髓鞘溶解症常规MRI及DWI表现

MR and DWI Imaging of Central Pontine Myelinolysis after Liver Transplantation

目的:探讨肝移植术后桥脑中央髓鞘溶解症的临床和MRI表现,提高诊断水平。方法:3例原位肝移植术后患者分别于术后3～21d出现神志不清、嗜睡、双下肢肌力减低等表现,均于2d内行MRI扫描,总结MRI表现及诊断要点。结果:MRI表现为桥脑中央对称性稍长T1、较长T2信号,DWI均为高信号,ADC为低信号。2例病灶累及大脑皮层,1例并发基底节脑脓肿。2例患者35d和2个月后复查MRI,病变范围明显变小,边界变清,DWI为等信号。结论:肝移植患者电解质紊乱可导致桥脑中央髓鞘溶解症,MRI具有典型的表现,根据MRI可做出正确诊断。

Objective To study the clinical and MRI features of central pontine myelinolysis after liver transplantation. Methods 3 cases of orthotopic liver transplantation patients, displaying unconsciousness, drowsiness, reduced muscle strength of both lower extremities 3 to 21 days after the operation respectively, went through MRI scan in 2 days.Results MRI showed that symmetric long T1 and T2 signals, high-signal-intensity DWI and low-signal-intensity ADC were found in central pontine region. The cerebral cortex was involved in 2 cases, and abscess in basal ganglia appeared in 1 case. MRI examination showed that 2 cases had decreased lesion range, clear boundary and equal-signal-intensity DWI 35 days and 2 months respectively after. Conclusion MRI is valuable for the diagnosis of the patient with central pontine myelinolysis after liver transplantation.