灰质异位症的CT表现和分型

CT Appearance and Classification of Gray Matter Heterotopias

目的 分析灰质异位症 (GMH)CT表现。材料与方法 搜集经CT检查发现的GMH 10例 ,其中男 3例 ,女 7例。儿童组 7例 ,年龄 2～ 11岁 ,平均 5 .9岁 ,均有智力发育障碍 ,伴癫痫者 2例。成人 (对照 )组 3例 ,年龄分别为 2 0、2 2和 76岁 ,均为意外发现。早期病例 ( 1993年前 ) 5例 ,应用颅脑CT机作平扫加增强。后期病例 5例 ,应用全身CT机作单纯平扫。结果 单灶 4例 ,双灶 5例 ,3灶 1例 ,共计有病灶 17处。团块状 10处 (均为儿童组 ) ,结节状 3处 (儿童组 1例 ,成人组 2例 ) ,串珠状 2处 (成人组 1例 ) ,环带状 2处 (儿童组 1例 )。全部团块状、串珠状和环带状以及 1处结节状与室管膜相连 ,2处结节状位于皮质下白质内。室管膜下病灶突入脑室使脑室变形 ,1例病灶压迫右室间孔致单侧性脑积水 ,伴胼胝体发育不全 4例 ,透明隔缺如 2例 ,枕大池扩大、蛛网膜囊肿不除外 1例。结论 依据本组病例及文献报道提出如下分型 :根据病变范围可分为局灶型和弥漫型 (带状 )。根据病灶是否与室管膜相连又可分为室管膜下和非室管膜下 2种。本组 17处病灶中室管膜下局灶型 ( 13 /17)占 76.4% ,弥漫型 ( 2 /17)占 11.8% ;非室管膜下局灶型 ( 2 /17)占 11.8% ,弥漫型未见。轻型GMH在儿童期较少发病 ,不易在儿童期发现。在儿童期?

Objective To analyze CT appearances of gray matter heterotopia (GMH).Materials and Methods CT findings in 10 cases with GMH, including 7 children and 3 adults, were analyzed. All children, aged 2～11 with a mean of 5.9 years, had epilepsy, and 2 showed mental retardation. The 3 adult patients were found accidentally.Results (1) Lesion number: single (n=4), two (n=5), three (n=1). (2) The appearance of lesion: mass (n=10, only seen in children group), nodules (n=3), beads (n=2), ring band (n=2). (3) Location: all masses, beads, ring band and one nodule were connected with ependyma, 2 nodules were in subcortical white matter. (4) Accompanying changes: deformation of ventricles due to the projection of subependymal lesion; unilateral hydrocephalus due to the oppression of ipsilateral interventricular foramen produced by subependymal lesion (n=1); dysplasia of corpus callosum (n=4); lack of septum pellucidum (n=2); arachnoid cyst (n=1). Conclusion According to the lesion distribution, heterotopia can be divided into local type and diffuse type. Based on the relationship of lesion and ependyma, heterotopia can be sub divided into subependymal type and non subependymal type. In this study, subependymal local lesions (13/17, 76.4%), subependymal diffuse lesions (2/17, 11.8%), and non ependymal local lesions (2/17, 11.8%) are found, while no non ependymal diffuse lesions are seen. Sever GMH with large lesion and deformity is more common in children.