临床特征和磁敏感分析脑淀粉样血管病相关脑叶出血

Diagnosis of cerebral lobe hemorrhage associated with cerebral amyloid angiopathy according to its clinical characteristics and GRE/SWI

目的应用临床特征和磁敏感分析脑淀粉样血管病(cerebral amyloid angiopathy,CAA)相关脑叶出血,旨在提高临床对其的诊断能力。方法收集2013年4月15日~2015年7月19日在内蒙古自治区人民医院神经内科住院的CAA相关脑叶出血患者34例,行头颅MRI T2加权、梯度回旋波T2加权及磁敏感加权成像,人口统计学和临床资料来源于病历记录,基本信息包括年龄、性别、既往史(高血压、糖尿病、抗血小板药物的使用等)和临床表现。结果 34例患者中,进行性痴呆、记忆功能下降5例;癫痫起病4例;既往有脑出血7例;高血压18例。头颅磁敏感加权成像显示,出血形态有圆形、卵形、卵圆形,出血位于顶叶、枕叶、额叶和颞叶,单脑叶出血7例和多脑叶出血27例。结论 CAA相关脑叶出血临床特点存在高度异质性,磁敏感加权成像磁共振检查在CAA临床方面具有重要的应用价值和推广价值。

Objective To improve the diagnosis of cerebral lobe hemorrhage（CLH）associated with cerebral amyloid angiopathy（CAA）according to its clinical characteristics and GRE/SWI.Methods Thirty-four CAA-related CLH patients admitted to Inner Mongolia People＇s Hospital for GRE/SWI from 2013-04-15 to 2015-07-19 were included in this study.Their demographic data,clinical data（age,gender,past history of hypertension,diabetes mellitus,use of antiplatelet drugs）and clinical manifestations were recorded.Results Of the 34 patients,5 were diagnosed with progressive dementia and hypomnesis,4 were diagnosed with epilepsy,7 were diagnosed with past cerebral hemorrhage,18 were diagnosed with hypertension.SWI showed that the CLH was round and oval in shape and was located in parietal lobe,occipital lobe,frontal lobe and temporal lobe respectively with single lobe hemorrhage occurred in 7 patients and multiple lobe hemorrhage occurred in 27 patients.Conclusion The clinical characteristics of CAA-related CLH are highly heterogeneous.SWI plays an important role in diagnosis of CLH and is thus worthy of popularizing its clinical application.