脑皮质层状坏死的MRI影像诊断

The MRI diagnosis of cerebral cortical laminar necrosis

目的：探讨脑皮质层状坏死（CLN）的MRI影像特点,提高对本病的认识。方法：回顾性分析2012年1月—2014年10月我院神经内科诊治的17例CLN患者的MRI影像资料,总结其MRI影像特点。结果：17例中双侧大脑半球病变3例,单侧大脑半球病变14例。1个脑叶受累11例,2个脑叶受累4例,多个脑叶受累2例。CLN检出时间为12~32 d。病变于MRI T1WI及FLAIR上均表现为脑回状高信号,MRA原始图像上显示更清晰;DWI上12例呈高信号,但信号较T1WI上弱,T2WI上病变显示不清,6例辅助SWAN检查均未发现与皮层高信号范围相符的出血灶。结论：CLN具有典型的MRI影像特征,即T1WI呈脑回状高信号,结合临床病史不难诊断。

Objective： To investigate the MR imaging features of cerebral cortical laminar necrosis （CLN）. Methods： The MR imaging materials of 17 CLN patients diagnosed in our hospital ranged from January 2012 to October 2014 were retro- spectively analyzed. The MRI characteristics were studied. Results： CLN was detected from 12 to 32 d since the patients were admitted. The affected regions were bilateral cerebral hemisphere （3/17）, unilateral cerebral hemisphere （14/17）, then the single lobe（l 1/17）, double lobes（4/17）, multiple lobes（2/17）. On MRI, the gyral shape lesion showed high intensity on T,WI and fluid- attenuated inversion-recovery （FLAIR）, lesions showed more clearly on original three dimensional time of flight magnetic reso- nance angiography （3D-TOF MRA） images, ill defined on T2WI, 12 patients manifested as high intensity on DWI. No hemor- rhagic focus showed on SWAN in 6 patients. Conclusion： Typical imaging features could be revealed in CLN, which is high intensity on MRI T1WI. Accurate diagnosis could be obtained with imaging examination in combination with clinical history.