脑出血后锥体束继发性损害的磁共振成像研究

A study of the characteristics of pyramidal tract lesions secondary to cerebral hemorrhage on Magnetic Resonance Imaging

目的探讨脑出血后锥体束继发性损害的磁共振成像(MRI)特点及意义。方法回顾性分析住院治疗首次单发病灶,伴有锥体束不同程度损害,曾于急性期(7天)内及亚急性期(21天)后分别进行头颅MRI检查的脑出血患者,同时分析在第二次MRI资料的T2/FLAIR图像上,在同侧远离血肿下方的大脑脚、脑桥及延髓出现异常信号患者的MRI资料。结果本组11例患者,男10例,女1例。MRI显示,第一次MRI检查中,所有患者在同侧远离血肿部位下方的大脑脚、脑桥、延髓等平面无异常信号;在第二次检查的T2/FLAIR图像上,所有患者在同侧远离血肿部位下方的大脑脚、脑桥、延髓等一个或多个平面上出现边缘不清的异常信号,其中2例为低信号,余9例为高信号。结论 MRI可以检测到局灶性脑出血后锥体束继发损害的现象,这种现象不应被误解为新发脑梗死或其他病变。

Objective To investigate the characteristic and significance of the secondary pyramidal tract （PT） lesions following cerebral hemorrhage on Magnetic Resonance Imaging （MRI）. Methods The data of MRI records from the patients with firstlydiagnosed and single lesion of cerebral hemorrhage complicated with different degrees of PT lesions were reviewed retrospectively. Brain MRI acquisition for patients in the acute stage （7days） and suba cute stage （21days） were performed, respectively. Abnormal intensity signals on T2 weight/FLAIR MR images for scaning the ipsilateral cerebral peduncle, pons or medulla oblongata remoted to initial lesion were reviewed on sec ond MRI acquisition at the same time. Results 11 cases were enrolled, 10 males and 1 female. At first MRI ac quisition, no abnormal intensity signals were obtained in cerebral peduncles, pons or bulbus. At second MRI acquisi tion for all cases, obscure and abnormal signals were obtained in one or multiple planars of ipsilateral cerebral pedun cles, loons or bulbus scanning, 9 cases of them with hyperintense signals and 2 cases of them with hypointense signals presented on Tz weight/FLAIR images. Conclusion The secondary PT lesions following cerebral hemorrhage can be identified on MRI, and this secondary lesion should not be misinterpreted as a newly developed infarction or other disease.