海洛因海绵状白质脑病的影像学特征

The image features of heroin spongiform leukoencephalopathy

目的 探讨海洛因海绵状白质脑病 (HSL E)的 CT、MRI和 PET特点。方法 对 2 9例患者的CT、MRI以及 4例患者的 PET资料进行分析。结果 (1) CT和 MRI显示病变位于双侧小脑、内囊后肢、枕顶叶深部等部位白质 ,病灶广泛且对称 ;(2 ) CT示界限清楚的低密度病灶 ,MRI呈长 T1 WI、长 T2 WI异常信号 ,无水肿 ,快速反转恢复序列 (FL AIR)和增强扫描提示血脑屏障无破坏 ,PET显示为低代谢或无代谢病灶 ;(3)未治疗患者内囊后肢、枕叶和小脑白质无代谢 ,康复期患者代谢明显减低 ;(4 )临床症状改善者和未治疗者小脑皮质代谢降低 ,临床症状明显改善者代谢正常。结论 HSL E患者的 CT和 MRI改变多局限于白质 ,极为相似。 PET显示病变部位低代谢或无代谢 ,小脑皮质和白质代谢的恢复对 HSL E患者的临床转归非常重要 ,故判断 HSL E患者的转归 ,PET较之

Objective To explore the CT, MRI?PET features of Heroin Spongiform Leukoencephalopathy (HSLE).Methods CT and MRI of 29 patients, and PET of 4 patients were analysed.Results 1.CT and MRI showed extensive and symmetric lesions in white matters of bilateral cerebellum,posterior crus of internal capsule and parieto occipital region;2.Cerebral CT showed hypodense areas, MRI showed corresponding areas with decreased signal intensity on T1 weighted images and increased signal intensity on T2 weighted images, no edema, FLAIR and enhancing scan showed no destruction of brain blood barrier, PET imaging showed hypometabolism or non metabolism changes in corresponding areas; 3. PET imaging showed non metabolism areas in untreated patients' posterior limb of internal capsule, parietooccipital lobes and cerebellum, and the metabolism in corresponding areas of improved patients was low obviously; 4.PET imaging showed hypometabolism in grey matter of untreated and improved patients, and the metabolism in the grey matter remarkable improved patient was normal.Conclusion CT and MRI changes of HSLE sufferers almost limited in brain white matters, PET imaging showed hypometabolism or non metabolism changes in corresponding areas, the metabolism improvement in grey and white matters was very important to the improvement of HSLE sufferers, PET was more appropriate than MRI to the prognoses of HSLE sufferers.