慢性酒精中毒性精神障碍患者脑磁共振研究

Brain magnetic resonance imaging in patients with chronic alcoholic mental disorders

目的探讨慢性酒精中毒性精神障碍患者的脑部磁共振的特征性表现,为临床诊断与治疗提供依据。方法将114例慢性酒精中毒性精神障碍患者依据初次饮酒年龄及酒龄分成两组,将初次饮酒年龄<18岁,酒龄≥10a60例患者设为研究组,将初次饮酒年龄≥18岁,酒龄<10a的54例患者设为对照组,两组均行颅脑3.0T超导磁共振检查,比较两组磁共振常规平扫、磁共振弥散成像检查结果。结果本组114例患者均有不同程度的脑萎缩表现,其中伴有脑梗死和/或脑白质脱髓鞘54例,特征性磁共振表现32例(胼胝体变性19例、韦尼克脑病11例、脑桥中央髓鞘溶解症3例,其中1例同时具有胼胝体变性和威尼克脑病的MRI表现)。分组比较发现:磁共振常规平扫研究组重度脑萎缩、胼胝体变性、韦尼克脑病检出率显著高于对照组(P<0.05或0.01);研究组在DWI序列呈高信号及略高信号,表观弥散系数图(ADC)呈低信号或稍低信号的侧脑室周围、半卵圆中心、胼胝体病灶检出率显著高于对照组(P<0.05)。结论脑部磁共振检查对慢性酒精中毒性精神障碍患者具有较高的诊断价值,对临床治疗具有重要指导意义。

Objective To explore the characteristics of brain magnetic resonance imaging(MRI)in patients with chronic alcoholic mental disorders,and to provide evidence for clinical diagnosis and treatment.Methods 114 patients with chronic alcoholic mental disorders were divided into two groups according to the age of first drinking and the age of drinking.60 patients with the age of first drinking<18 years,and the age of drinking>10 years were set up as the study group.54 patients with the age of first drinking>18 years,and the age of drinking<10 years were set as the control group.Both groups underwent 3.0T superconducting MRI,and the results of routine plain scan and diffusion magnetic resonance imaging were compared.Results 114 cases of patients have different degree of cerebral atrophy,54 cases were associat-ed with cerebral infarction and/or brain white matter demyelination,32 cases had characteristic magnetic resonance(corpus callosum degeneration 19 cases,wernicke encephalopathy 11 cases,central pontine myelinolysis 3 cases,1cases with corpus callosum degeneration and MRI manifestation of Nick encephalopa-thy).Group comparison showed that the detection rate of severe brain atrophy,corpus callosum degeneration and wernicke's encephalopathy in the study group was significantly higher than that in the control group(P<0.05 or 0.01).The study group showed a high signal and a slightly higher signal in the DWI sequence,and a low signal or a slightly lower signal in ADC,the detection rate of the lateral ventricle,semi-oval center and corpus callosum in the study group was significantly higher than that of the control group(P<0.05).Conclusion Brain MRI is of high diagnostic value in patients with chronic alcoholic dyspraxia and has important guiding significance for clinical treatment.