急性Marchiafava-Bignami病临床特点及MRI表现

Clinical features and MRI appearances of Marchiafava-Bignami disease

目的 分析急性Marchiafava-Bignami disease（MBD）的临床特点及磁共振表现。方法 回顾性分析6例急性MBD临床资料及磁共振影像学表现。结果 6例均为男性,年龄47~68岁,患者均有长期饮酒史,临床表现以不同程度的意识障碍、行为异常最为常见。颅脑MRI结果：4例胼胝体全部受累,1例为胼胝体压部受累,1例胼胝体全部受累伴有双侧脑室旁白质受累;病变主要为T1加权低信号,T2加权高信号,弥散加权（diffusion-weight imagine,DWI）高信号,液体衰减反转恢复成像（fluid attenuated inversion recovery,FLAIR）表现为高信号,全部患者均给予维生素B1、B12肌肉注射治疗,5例患者预后良好,1例遗留肢体抽搐。结论 急性MBD临床表现缺乏特异性,诊断主要依据慢性酗酒病史和颅脑影像学表现,早期诊断对于急性MBD患者预后有重要意义。

Objective To investigate the clinical features and MRI findings of acute Marchiafava-Bignami disease （MBD）. Methods We retrospectively analyzed clinical data and MRI manifestations of 6 cases of acute MBD. Results In 6 males, aged 47-68 years old, all had alcoholics for years. Acute cognitive impairment and abnormal behavior were the most common clinical manifestations. MRI results： The corpus callosum were all involved in 4 cases, splenial lesion in- volved in 1 case, corpus callosum and both peri-ventricular white matter involved in 1 case. Lesions were shown low-inten- sity in T1WI, high-intensity in T2 WI, diffusion-weight imagine （DWI） and fluid attenuated inversion recovery （FLAIR） lesions of the corpus callosum. All were treated with VB1, VB12. Five patients had good prognosis, one case left limbs seizures. Conclusion Clinical manifestations of acute MBD are nonspecific, diagnosis relies on history of alcoholism and the brain MRI. Early diagnosis of MBD was significant for prognosis.