MELAS综合征的多模态MRI诊断价值分析

Multimodal MRI diagnosis and analysis of MELAS syndrome

目的探讨多模态MRI在MELAS综合征早期诊断中的临床应用价值。方法选取19例临床确诊的MELAS综合征患者的多模态MRI资料,全面分析患者的多模态MRI特征。结果19例患者的常规MRI显示,大脑皮层或皮层下在T_(1)WI为较低信号,在T_(2)WI为较高信号,在FLAIR为较高信号,在DWI为较高或高信号,在ADC为低或等信号。5例患者行对比增强扫描,2例未显示增强,3例出现轻度线状增强。本组5例随访患者病灶均为游走性。13例患者行MRA检查,发现病变部位动脉供血血管无狭窄征像,反而6例显示血管增粗、增多。9例患者行ASL扫描,均显示不同程度的灌注升高。8例患者行MRS扫描,7例显示乳酸峰明显增加。结论MELAS综合征在MRI中具有较特异的表现,多模态MRI在MELAS综合征的早期诊断中具有重要价值。

Objective To explore the clinical application value of multimodal magnetic resonance in the early diagnosis of MELAS syndrome.Methods We retrospectively analysed the multimodal magnetic resonance imaging data of 19 clinically diagnosed MELAS syndrome patients,and comducted comprehensive analysis of the patients'multimodal magnetic resonance characteristics.Results The conventional magnetic resonance imaging of 19 patients showed that the cerebral cortex or subcortex showed lower signal on T_(1)WI,higher signal on T_(2)WI,higher signal on FLAIR,and higher signal on DWI,low or equal signal on ADC.5 patients underwent a contrast-enhanced scan,2 patients showed no enhancement,and 3 patients showed mild linear enhancement.The lesions of the 5 follow-up patients in this group were all migratory.13 patients underwent MRA examination and found that the lesion site was inconsistent with the arterial blood vessel,and there was no sign of vascular stenosis,and 6 patients showed thickening and increasing of blood vessels.9 patients underwent ASL scan,and all showed varying degrees of increased perfusion.8 patients underwent MRS scan,and 7 patients showed a significant increase in the lactate peak.Conclusion MELAS syndrome has a more specific manifestation in magnetic resonance imaging,and multimodal magnetic resonance is of great value in the early diagnosis of MELAS syndrome.