非酮症高血糖性偏侧舞蹈症的临床及影像学特征

Clinical and imageology characteristics of non-ketotic hyperglycemia hemichorea

目的探讨非酮症高血糖性偏侧舞蹈症(hemichorea associated with non-ketotic hyperglycemia,HC-NH)的临床表现及影像学特征。材料与方法回顾性分析8例(男︰女=3︰5,年龄介于51~80岁)HC-NH患者的临床表现和影像学资料。结果8例均为老年2型糖尿病(type 2 diabetes mellitus,T2DM)患者,急性起病,表现为单侧肢体不自主舞蹈样运动,血糖升高,糖化血红蛋白升高,尿酮体阴性,MRI平扫示8例均累及基底节区,6例为左侧,2例为右侧,累及左侧尾状核头、豆状核3例,累及左侧壳核2例,累及左、右侧尾状核头、壳核各1例,累及右侧尾状核头1例;T1WI序列8例均呈高信号;T2WI序列4例呈等信号,3例呈稍低信号,1例呈略高信号;T2WI-FLAIR序列呈不均匀等及稍高信号;DWI序列5例呈等信号,3例呈略低信号。2例行CT平扫呈高密度。结论HC-NH临床表现为高血糖患者不自主舞蹈样运动,MRI表现具有特征性。

Objective:To explore the clinical manifestations and imageology characteristics of hemichorea associated with non-ketotic hyperglycemia(HC-NH).Materials and Methods:The clinical and imaging data of 8 cases(male︰female=3︰5,age between 51 and 80 years)of HCNH were analyzed retrospectively.Results:All the 8 cases were elderly T2DM patients,acute onset,characterized by unilateral involuntary choreiform movements,hyperglycemia,urine ketone negative,all involved the basal ganglia,6 cases were left and 2 cases were right,the left head of caudate nucleus and the lentiform nucleus were involved in 3 cases,the left putamen was involved in 2 cases,the left head of caudate nucleus and the putamen were involved in 1 case,the right head of caudate nucleus were involved in 1 case,the right head of caudate nucleus and the putamen were involved in 1 case.T1-weighted imaging showed hyperintensity in all 8 cases,T2-weighted imaging showed isointensity in 4 cases,slightly lower hypointense in 3 cases and slightly hyperintensity in 1 case.T2-FLAIR sequence showed inhomogeneous hype-isointense in all 8 cases,DWI sequence showed isointensity in 5 cases,slightly lower hypointense in 3 cases,2 cases in CT scan showed high density.Conclusions:The clinical manifestations of HC-NH are nonketotic hyperglycemia,unilateral involuntary choreiform movements,and MRI is characterized.