OPCA的MRI影像诊断与临床

MRI diagnosis and clinical manifestation of OPCA

目的：探讨ＯＰＣＡ的ＭＲＩ征象，及与临床表现的关系。方法：回顾性分析３０例ＯＰＣＡ的ＭＲＩ影像学表现。结果：根据ＭＲＩ征象将ＯＰＣＡ分为轻、中和重度３度。本组轻度者５例，中度者８例，重度者７例。轻度者：小脑脑沟增多、加深，脑干略变细，桥脑无明显改变。中度者：除前者征象外，可见桥脑腹侧萎缩，四脑室扩大，脑干周围基底池扩大。重度者：小脑、桥脑腹侧，延髓橄榄重度萎缩，小脑核，桥脑被盖，小脑下部不受累。临床症状以小脑性共济失调为主且是首发症状，占２３例（７６．６％），双下肢乏力４例（１３．６％），帕金森氏综合征２例（９．４％）；精神异常１例（３．４％），其它症状共占１６．２％（包括闪电样疼痛，括约肌障碍，吞咽困难，视力减退，精神运动退变等）。结论：ＭＲＩ可清楚显示 ＯＰＣＡ的病变程度，Ｔ１Ｗ像矢状位显示最佳，临床表现与 ＭＲＩ所示病变程度密切相关。

Objective To study the MRI signs of OPCA and the relationship with clinical manifestion.Methods:30 cases of MRI manifestion of OPCA were reviewed retorseperctively. Results: According to the MRI signs, these 30 cases were divided into 3 types, mild degree 5 cases,moderate degree cases indicated that their cerebellar fold increased and deepened, brain stem slightly became thin, pontine had no clearly atrophy.To the mod- erate ones, except having all the signs of the mild ones,they showed that their pontine internal side atrophied ,four encephalocoeles,brain stem basi- laris pool dilated,the severe ones indicated that cerebell,pointine internal side and bulbaroliver seriously atrophied. According to the clinical observa- tion,the clinical manifestation mainly indicated cerebellarataxia, and 23 cases (76.6%) presented primary symptom, 4 cases (13.6%) presented two lower limbs fatigued,2 cases (9.4%)appeared Pakinsonian syndrome and 1 cases (3.4%)presented mental disorders. There are another symptom (16.2% ) (such as glistening ache,language disorders,swallow distress,eyesight weakened,mental movement degeneration and so on). Conclusion: MBI could clearly indicate the pathological changes degree of OPCA T1 W sagittal sections indication os excellent. Clinical manifestion has close rela- tionship with the pathological changes degree that MRI indicated.