淀粉样脑血管病临床与磁共振诊断分析

Analysis of Clinical and MRI diagnosis of cerebral amyloid angiopathy

目的分析淀粉样脑血管病(CAA)的临床及磁共振特点,以提高对该病的认识并指导治疗。方法 16例淀粉样脑血管病患者均行头颅磁共振常规MRI及磁敏感加权序列(SWI)检查。结果 16例患者均明确诊断为脑出血。MRI显示10例为多发部位出血,6例单发出血。出血部位多位于脑叶,3例并发蛛网膜下腔出血,1例并发脑室出血。急性期、亚急性期、慢性期出血混合存在。SWI示出血病灶呈明显片状低信号,皮层下区显示大量弥散分布点状极低信号影。结论淀粉样脑血管病确诊须病理诊断,有自身的临床和磁共振特点,SWI可为临床诊断提供更加可靠的依据。

Objective To analyze the clinical and MRI characteristics of cerebral amyloid angiopathy（CAA）,and to improve the understanding of the disease.Methods Retrospective analysis was carried out on 16 cases of CAA patients diagnosed by MRI.Results The cases aged from 53 to 82,14 of them are male and 12 are female.All of them were implemented craniocerebral conventional MRI and susceptibility weighted imaging（SWI）and cerebral hemorrhage was clearly diagnosed.Ten cases showed multiple sites of hemorrhage while 6cases showed single site of hemorrhage.Most of the sites were in lobes.Three cases were complicated with subarachnoid hemorrhage and 1case with ventricular hemorrhage.Acute,subacute and chronic hemorrhage existed mixedly.Bleeding lesions was obvious platy low signal in SWI and subcortical area shew a large number of scattered point extremely low signals.Conclusion The determination of CAA needs pathological diagnosis but it is often hard to do clinically.CAA has its own clinical and MRI features so SWI may provide more reliable evidence for its clinical diagnosis.