麻痹性痴呆的MRI表现（附32例报道）

MRI findings in patients with general paresis of insane： a report of 32 eases

目的探讨麻痹性痴呆（GPI）的MRI特征和诊断价值，提高对GPI患者MRJ表现的认识。方法中山大学第三附属医院放射科自2006年5月至2010年11月共诊断GPI患者32例，回顾性分析患者的临床资料并总结GPI的MIu表现。结果本组患者的MRI表现分为两型：脑萎缩型（30例1和脑肿胀型（2例），其中脑萎缩型GPI的MRJ表现为：（1）以颞叶、额叶、海马、胼胝体萎缩为主，脑白质萎缩较脑皮质萎缩明显；（2）杏仁体及海马形态异常及伴T2信号增高；（3）皮层／皮层下“脑回状”T2信号增高，以岛叶多见；（4）双侧豆状核对称性T2信号减低；脑肿胀型GPI的MRJ表现为弥漫型或局灶型。结论GPI的MRI表现多样，但具有一定特征性．结合临床表现和相关实验室检查结果可作出正确诊断。

Objective To evaluate the MRI findings in patients with general paresis of insane （GPI） to enhance the understanding of MRI diagnosis of this disease. Methods The clinical data and MRI findings of 32 patients with GPI, admitted to our hospital from May 2006 to November 2010, were retrospectively analyzed. Results The MRI findings of GPI were mainly divided into 2 types： cerebral atrophy （n=30） and cerebral swell （n=2）. The major MR/findings in the type of cerebral atrophy included white cerebral atrophy in the temporal lobe, the frontal lobe, the hippocampus and the corpus callosum, morphological changes and T2 hyperintensity in the amygdaloid body and the hippocampus, gyral T2 hyperintensity in the cortex and subcortex, and T2 hypointensity in the lenticular nucleus. The MRI findings in the type of cerebral swell manifested as suffused and focal types. Conclusion The MRI findings in GPI are multiple with some characteristic manifestations. Diagnosis must be made through the combination of imaging features with clinical data and related laboratory tests.