肥大性下橄榄核变性的MRI表现

MRI findings of hypertrophic olivary degeneration

目的:探讨肥大性下橄榄核变性(HOD)的MRI表现特征。方法:回顾性分析14例HOD患者的临床及影像学资料。14例均行常规磁共振平扫(T1WI、T2WI、T2FLAIR),8例行DWI检查,2例行扩散张量纤维束成像(DTT)检查。结果:14例HOD中6例为单侧(左侧5例,右侧1侧)发病,8例为双侧发病。12例原发病变为桥脑出血,1例为单侧小脑梗死,1例为双侧小脑萎缩。MRI表现为下橄榄核T2WI呈高或稍高信号,T1WI呈等或稍低信号,DWI呈等信号。7例下橄榄核存在不同程度的肿胀、肥大。1例DTT示患侧神经纤维束减少。结论:HOD多继发于齿状核-红核-下橄榄核环路病变,有特定的发病部位和较为特征性的MRI表现,结合其原发病变可对HOD作出正确诊断。

Objective：To study the MRI features of hypertrophic olivary degeneration （HOD）. Methods.. The clinical and MRI materials of 14 patients with HOD were retrospectively analyzed. All patients underwent routine MR scanning （T1 weighted,T2 weighted and T2 FLAIR sequences）. 8 patients had DWI, 2 patients also had DTT. Results： Among these 14 patients, 6 patients had unilateral lesion （left n= 5 ; right n = 1）, 8 patients had bilateral lesions. The primary disease were hemorrhage in pons （12 patients）, unilateral cerebellar infarct, bilateral cerebellum atrophy for 1 patient each. The MRI findings of HOD were hyperintensity on T2 WI at olivary complex for all patients,isointensity or mild hypointensity on DWI for 8 patients. 7 patients had various degree of olivary hypertrophy. DTT showed reduce of neurofiber on the involved side in 1 patient. Conclusion.. HOD is often secondary to a lesion within the Guillain Mollaret Triangle, characteristic MRI features could be revealed. Correct diagnosis could be obtained when the primary lesion is taken into consideration.