急性一氧化碳中毒后迟发性脑病的临床表现、CT及MRI

Study of delayed encephalopathy after acute carbon monoxide poisoning by clinical characteristic, CT and MRI features

目的 :探讨急性一氧化碳中毒后迟发性脑病 (DEACMP)患者的头部CT及磁共振成像 (MRI)改变的特点和诊断价值。方法 :分析 2 0例DEACMP患者的临床表现、CT及MRI资料。结果 :DEACMP患者的主要临床表现为智能、人格改变 ;头部CT的特征表现为双侧大脑白质弥漫性低密度改变 ,以两侧或单侧基底节区或苍白球区低密度改变最明显 ;MRI表现为脑室周围白质和半卵圆中心双侧对称的点状、斑片状或融合性病灶 ,T2 加权呈高信号 ,T1加权呈低信号 ,基底节或苍白球区呈慢性缺血性改变。偶见病灶主要位于大脑皮层。结论 :本病的诊断主要依靠病史、临床表现和影像学检查。头部MRI对本病的诊断。

Objective To explore the diagnosis value of CT and MRI in delayed encephalopathy after acute carbon monoxide poisoning (DEACMP). Methods The clinical, CT and MRI data of 20 patients with DEACMP were analysed. Results The main clinical manifestations of the disease were intellectual disturbances and personality disorders. CT scan in DEACMP showed that some characteristic changes (such as diffuse low density) was observed within bilateral cerebral white matter, prominently within bilateral or unilateral globus pallidus or basal ganglia areas. The MRI showed that brain lesions in DEACMP were bilateral symmetric punctate, spotty or confluent foci within periventricular white matter and centrum semioval, which showed high signal intensity in T 2 weighted and low signal intensity in T 1 weighted. The chronic ischemia changes were found in the globus pallidus or basal ganglia areas. Cerebral cortex lesions were observed occasionally. Conclusions The diagnosis of DEACMP mainly depends on case history, clinical features and neuroradiological presence. MRI is more valuable in the diagnosis and the differential diagnosis than CT.