锥体束Wallerian变性的CT及MRI诊断

CT and MRI findings of Pyramidal Wallerian degeneration

目的研究Wallerian变性的CT及MRI表现,以期应用合适的影像检查方法提高诊断正确率。方法回顾性分析原发性脑损伤后28例Wallerian变性的CT及MRI资料。结果 28例中,9例脑损害12～24周患者Wallerian变性直接征象表现为在磁共振上与病灶同侧沿锥体束走行路径条状等、长T1长T2信号,19例原发性脑损伤后2～6年患者间接征象为与脑损害同侧的脑干萎缩;CT仅在变性后期可显示脑干萎缩或局部低密度影。结论 MRI是诊断Wallerian变性的可靠方法。

Objective To investigate CT and MRI manifestations of Wallerian degeneration and choose ap- propriate imaging method to improve the diagnostic accuracy. Methods The CT and MRI findings of Wallerian degeneration in 28 cases were regressing analyzed in association with the primary intraeranial lesions. Results Iso-T1 or long-T1 and long-T2 signal strip regions were demonstrated along ipsilateral pyramidal tracts as direct signs in 9 patients 12 to 24 weeks after the primary injury, and atrophy of the ipsilateral brainstem as indirect signs was demonstrated in 19 cases 2 to 6 years after the primary insult. Atrophy and local low-density can be demonstrated on CT in later period. Conclusion MRI is valuable in the diagnosis of Wallerian degeneration.