MR DWI与常规MRI对Creutzfeldt-Jakob病的诊断价值比较

Comparing the Diagnostic Value of Diffusion Weighted Imaging and Conventional magnetic resonance imaging in Creutzfeldt-Jakob Disease

目的比较MR扩散加权像(DWI)与常规MRI对Creutzfeldt-Jakob病(CJD)的诊断价值。方法总结我院10例散发性CJD患者的临床资料及MRI资料,比较DWI与常规MRI结果。结果 T1WI上仅1例显示两侧额叶大脑皮层带状稍低信号;T2WI上2例显示双侧大脑皮层带状高信号,伴或不伴基底节稍高信号,1例显示脑干、小脑、两侧基底节、两侧丘脑高信号,1例仅双侧基底节高信号;液体衰减反转恢复(FLAIR)序列4例显示双侧大脑皮层带状高信号,其中3例伴基底节高信号;1例显示脑干、小脑、两侧基底节、两侧丘脑高信号;1例仅显示两侧基底节高信号。5例6次增强扫描均未见明显异常强化。5例行DWI,其中4例示双侧大脑皮层带状高信号,伴或不伴基底节高信号;1例仅表现为两侧基底节高信号。病灶部位平均表观扩散系数(ADC)值为0.687×10-3mm2/s,较正常脑实质明显减低。结论 DWI显示CJD病变优于常规MRI,可为CJD的早期发现、早期诊断提供有价值的信息。

Objective To compare the diagnostic value of diffusion weighted imaging（DWI） and conventional MRI in Creutzfeldt-Jakob disease（CJD）.Methods Ten cases with sporadic CJD in our hospital were reviewed.Clinical and MRI information of these patients were analysed.Results T1WI showed linear lower signal in both sides of the frontal cortices in only 1（1/10） case.In T2WI,it showed linear high signal in bilateral brain cortices,with or without slightly high signal in basal ganglia in 2（2/10）cases.One case（1/10） showed high signal in brain stem,cerebellum,bilateral basal ganglia and bilateral thalami.Another one case showed high signal only in bilateral basal ganglia.Fluid Attenuated Inversion Recovery（FLAIR） showed linear high signal in bilateral brain cortices in 4（4/10）cases,thereinto,3 cases with high signal in basal ganglia.One case（1/10） showed high signal in brain stem,cerebellum,bilateral basal ganglia and bilateral thalami.Another one case showed high signal only in bilateral basal ganglia.No abnormity was found in 5 patients with contrast enhancement MRI.Five patients underwent DWI exam following conventional MRI.Four（4/5） of them showed linear high signal in bilateral brain cortices,with or without high signal in basal ganglia.The remaining 1 case（1/5） showed high signal only in bilateral basal ganglia.The average ADC values of lesions was 0.687×10-3mm2/s,which was much lower than normal brain tissues.Conclusion DWI is superior to conventional MRI in displaying CJD lesions,which is helpful for early detection and diagnosis of CJD.