散发性Creutzfeldt-Jakob病7例影像学特点分析

Imaging findings of 7 patients with sporadic Creutzfeldt-Jakob Disease

目的分析散发性Creutzfeldt-Jakob病(sCJD)的影像学特征,旨在提高临床医生对此病的认识和诊断水平。方法总结河北医科大学附属唐山工人医院2004—2009年临床诊断为sCJD的患者7例,对其病后第1～12个月进行头部影像学检查(CT、MRI)。结果所有患者头部CT检查未见底节区异常改变,3例可见脑萎缩;头部MRI检查可见1例双侧尾状核、壳核于T2加权像(T2WI)高信号,3例FLAIR序列呈对称性高信号,T1加权像无改变;6例分别可见双侧尾状核、壳核、丘脑弥散加权成像(DWI)上可见对称性高信号,2例DWI上可见皮层不对称性高信号,且异常信号随病情时间进展而变化。结论 sCJD临床表现以快速发展的进行性痴呆和肌阵挛最具特点,其影像学异常改变在特定的临床背景下可成为sCJD临床诊断依据之一。

Objective To study the imaging findings of sporadic Creutzfeldt-Jakob Disease （sCJD）. Methods The neuroimaging characteristics of 7 CJD patients were examined by CT and MRI 1 - 12 months after the onset. Results No changes were found in the basal ganglia by CT;3 cases showed brain atrophy. Symmetric bilateral high signals were observed in the caudate nucleus and putamen in T2-weighted imaging of one case and in FLAIR imaging of 3 cases;no changes were found in Tl-weighted imaging. Symmetric bilateral high signals were observed in caudate nucleus ,putamen and thalamencephalon in DWI imaging of 6 cases, and asymmetric bilateral high signals were observed in the cortex of 2 cases, and the signals changed along with time. Conclusion Symmetric high signal in bilateral caudate nucleus is an important imaging feature of sCJD ; it might serve as a diagnostic index under some clinical condition.