桥本氏脑病的MRI表现与临床对比

MRI manifestations and clinical analysis of Hashimoto encephalopathy

目的分析和研究桥本氏脑病患者的临床表现、诊断标准,MRI表现及预后。方法选取2009年以来病例12例,均检测抗甲状腺抗体、特别是抗甲状腺过氧化物酶抗体,并行脑电图检查,治疗前均行MRI、MRA检查,激素治疗6个月-2年,治疗后复查MRI、MRA。结果本组患者均表现为卒中样发作、精神症状、癫痫样发作等症状,检查抗甲状腺抗体增高,特别是抗甲状腺过氧化物酶抗体明显增高,脑电图脑内广泛异常慢波,MRI见脑内多发异常信号,MRA见脑内动脉多发狭窄,激素治疗6个月-2年,患者症状恢复,复查MRI、MRA,脑内异常信号大部分消失,MRA血管狭窄明显改善。结论桥本氏脑病MRI脑内多发异常信号,MRA脑血管多发狭窄,正确认识本病,可减少漏诊和误诊。

Objective To analyze and research clinical manifestations,diagnostic criteria,MRI manifestations and prognosis of Hashimoto＇s encephalopathy. Methods Cases since 2009,12 cases were selected,all testing anti- thyroid antibodies,especially the resistance to thyroid peroxidase antibody,parallel eeg examination,MRI,MRA examination were performed before treatment,hormone treatment for 6 months to 2 years,MRI and MRA review after treatment. Results This group of patients were characterized by sample seizures,mental symptoms of stroke,epileptic seizures and other symptoms,check anti- thyroid antibodies increased,especially the thyroid peroxidase antibody significantly higher resistance,abnormal eeg in the brain are widely slow wave,see multiple abnormal signals in the brain MRI,MRA see frequent brain artery stenosis,hormone treatment for 6 months to 2 years,patients with symptoms,MRI,MRA,review the brain most abnormal signal disappears,MRA vascular stenosis improved significantly. Conclusion Hashimoto encephalopathy multiple abnormal signals in MRI brain,MRA frequent cerebrovascular stenosis,understanding of the disease,can reduce missed diagnosis and misdiagnosis.