MRI对Creutzfeldt-Jakob病的诊断价值

Diagnostic value of MRI on Creutzfeldt-Jakob disease

目的探讨MRI对Creutzfeldt-Jakob病(CJD)的诊断价值。方法对15例CJD患者的影像学资料进行回顾性分析。结果15例CJD患者的临床诊断为很可能CJD10例,可能CJD5例;15例常规T1WI和T2WI序列扫描均未见异常信号;DWI序列扫描10例显示大脑皮质合并尾状核、壳核高信号改变,5例为单纯大脑皮质高信号改变;其中8例呈对称性,7例呈非对称性;4例行1H-MRS序列扫描显示不同程度的N-乙酰天门冬氨酸(NAA)、NAA/肌酸(Cr)下降,2例胆碱(Cho)、Cho/Cr升高、2例Cho、Cho/Cr下降,4例均未见肌醇(mI)峰显示。结论MRI,特别是DWI及1H-MRS序列扫描能够为早期发现及诊断CJD提供有价值的信息。

Objective ： To investigate the diagnostic value of MRI on Creutzfeldt-Jakob disease（CJD）. Methods The imaging data of 15 patients with CJD were analyzed retrospectively. Results In the 15 cases, the diagnosis was clinical probable CJD 10 cases, maybe CJD 5 cases. There was no abnormal signal found by routine T1WI and T2WI scanning in the 15 cases. DWI showed that 10 cases had hyperintense abnormalities in both the cerebral cortex and the striatum, 5 cases had hyperintense abnormalities only in the cerebral cortex. The hyperintense abnormalities were symmetric in 8 cases,but were asymmetric in the other 7 cases. ^1H-MRS were applied in the 4 cases and showed that N-acetylas partate （ NAA ）, NAA/creatine （Cr） were decreased to some extent. Choline （ Cho ）, Cho/Cr were decreased in 2 cases and increased in 2 cases, mI peak did not appear in all 4 cases. Conclusion MRI, especially DWI and ^1H-MRS give can valuable information in detecting and diagnosing CJD early.