急性脑梗死后胼胝体压部可逆性病变MRI表现(附4例报道)

MRI features of transient lesion of the splenium of the corpus callosum after acute ischemic stroke:report of 4 cases

目的探讨急性脑梗死后胼胝体压部可逆行性病变的发生机制。方法收集4例急性脑梗死后胼胝体压部可逆行性病变患者行MRI检查,结合文献进行分析。结果急性脑梗死后1~2周内胼胝体压部出现DWI呈高信号,ADC低信号的新发病变,临床未见与新发病变相关症状,1~2个月后胼胝体压部DWI高信号病变消失。结论急性脑梗死后可逆性胼胝体病变是华勒氏变性早期改变,其应与脑梗死、可逆性胼胝体压部病变综合征及原发性胼胝体变性等疾病鉴别。

Objective To study the mechanism underlying transient lesions in the splenium of the corpus callosum(SCC)secondary to acute ischemic stroke.Methods 4 cases who showed transient lesions in the SCC secondary to acute ischemic stroke were described and analyzed according to the clinical and MR features,combined with the literature.Results Both patients showed a fresh lesion in the SCC on magnetic resonance imaging(MRI)1~2 weeks after the onset of stroke,with a hyperintense lesion on diffusion-weighted imaging and decreased apparent diffusion coefficient values,with no symptoms related to the lesion.In both cases,the lesion disappeared on MRI 1~2 months later.Conclusion Transient lesions in the SCC secondary to acute ischemic stroke are early wallerian degeneration after cerebral infarction.Clinicians should note that transient SCC lesions can occur following acute ischemic stroke and avoid misdiagnosing them.