肥大性下橄榄核变性的MRI浅析

MRI Features of Hypertrophic Olivary Degeneration

目的探讨肥大性下橄榄核变性(HOD)的MRI特征与临床表现,以期提高对该病的认识。方法回顾性分析16例HOD患者的MRI表现,原发病变为脑干出血6例,脑干梗死3例,脑干挫裂伤1例,脑干脑炎1例,小脑出血4例,小脑肿瘤1例。16例均行T1WI、T2WI、FLAIR序列扫描,其中10例加做扩散加权成像和磁敏感加权成像序列。结果 MRI表现为单侧或双侧下橄榄核体积增大或无明显变化,T1WI呈等或稍低信号,T2WI呈稍高或高信号,FLAIR呈等或稍高信号,扩散加权成像上呈等信号,表观扩散系数图上呈稍高信号,磁敏感加权成像上无异常信号,对出血病灶显示最好。与原发性病变发生同侧HOD 6例,发生对侧HOD 4例,发生双侧HOD 6例。结论 MRI能非常清楚地显示下橄榄核的变性改变,但需结合临床病史、症状与体征才能对HOD做出明确诊断。

Objective To explore MR appearances and clinical features of Hypertrophic Olivary Degeneration （HOD） , in order to improve the diagnosis. Methods MRI findings of 16 patients with HOD were retrospectively analyzed. The primary lesions were brainstem hemorrhage in 6 cases, brainstem infarction in 3 cases, 1 case brainstem contusion and lac-eration in 1 case, brainstem encephalitis in 1 case, cerebellar hemorrhage in 4 cases and eerebellar tumor in 1 case. 16 ca-ses underwent Tl WI,T2WI,FLAIR sequence and 10 cases underwent DWI and SWI sequence additional. Results HOD showed slightly low signal intensity on T1WI, slightly high or high signal intensity on T2WI, iso-or slightly high signal in-tensity on FLAIR, iso-intensity on DWI and slightly high signal intensity on ADC. SWI is good at demonstrating hemor-rhage lesions. HOD located at ipsilateral primary lesions was in 6 cases, contralateral in 4 cases, and bilateral in 6 cases. Conclusion MRI can clearly demonstrate the degeneration of inferior olivary nucleus, but definite diagnosis should be made combinded with clinical history, symptoms and signs.