脑灰质异位的临床及MRI特点

The clinical and MRI features of brain gray matter heterotopia

目的:探讨脑灰质异位的临床及MRI图像特点,以期提高本病的诊断率。方法:收集经临床及MRI诊断为脑灰质异位的20例患者的临床及影像学资料,总结脑灰质异位的MRI图像特点。结果 20例脑灰质异位患者中共发现病灶28个。其中单侧发病12例,双侧发病8例,多病灶者12例。室管膜下型8例,局灶性皮下型5例,弥漫型5例,混合型2例。其中2例患者伴发多微小脑回畸形,1例患者伴透明隔缺如。根据脑灰质异位部位的不同,可表现为不同的临床症状,主要为反复癫痫发作、肢体运动障碍、语言障碍及智力低下及头痛、耳鸣、视力下降等临床症状。所选患者均行T1WI、T2WI、FLAIR序列扫描,表现为脑白质内出现脑灰质信号,T1WI和T2WI表现为等皮质信号,并向脑白质深处延伸,脑室受压变形,具有占位效应,FLAIR显示病灶的清晰度明显优于T1WI及T2WI,增强扫描后病变部位无强化。结论:脑灰质异位的MRI表现具有特征性,对病变部位和病变范围的诊断具有重要的临床价值。

Objective To explore the clinical and MRI image of brain gray matter heterotopia characteristics,in order to improve the diagnosis of this disease. Methods Collecting the clinical and MRI diagnosis of brain gray matter heterotopia clinical and imaging data of 20 patients,summarizes the characteristics of MRI image of brain gray matter heterotopia. Results20 cases found in lesions in 28 patients with cerebral gray matter heterotopia. 12 cases with unilateral,bilateral incidence,8cases,12 cases were multiple lesions. Subependymal type 8 cases,focal subcutaneous type 5 cases,diffuse in 5 cases,mixed type in 2 cases. Including 2 cases of patients with multiple small gyri deformity,1 case of patients with transparent insulation is absent. According to different brain gray matter heterotopia,can show the different clinical symptoms,mainly for the recurrent seizures,body movement disorders,language barriers and low intelligence and headache,tinnitus,vision loss and other symptoms. In selected patients with T1 WI,T2WI and FLAIR sequences scanning,performance for cerebral gray matter in brain white matter signal,T1 WI and T2 WI manifestation of cortical signals,and extends to the depths of the cerebral white matter and ventricular compression deformation,with placeholder effect,is obviously better than the definition of FLAIR shows lesions T1 WI and T2 WI,enhanced scan without strengthening the lesion site. Conclusion MRI of brain gray matter heterotopia performance has the characteristic,the diagnosis of pathological changes and pathological scope has important clinical value.