糖尿病性非酮症偏侧舞蹈症的CT和MRI诊断

Brain CT and MR findings of non-ketotic hyperglycaemia hemichorea

目的:回顾性分析糖尿病性非酮症偏侧舞蹈症(hemichorea associated with non-ketotic hyperglycemia,HC-NH)患者脑部的CT及MRI影像学特点,提高对本病的认识。方法:选取益阳市中心医院2016年4月—2021年11月期间经临床确诊的5例HC-NH患者,患者均行头部CT、MRI平扫及头部磁共振血管成像(magnetic resonance angiography,MRA)检查。结果:5例HC-NH患者均累及基底节区,3例为左侧,2例为右侧,2例累及左侧尾状核头及豆状核,1例累及左侧壳核,累及右侧尾状核头和壳核2例。CT扫描病灶均为高密度,病灶边界清晰,周围无水肿,无占位效应。T_(1)WI序列5例均呈高信号;T_(2)WI序列呈稍低信号4例,呈等信号1例;FLAIR序列5例呈不均匀等或稍低信号;5例MRA均未见异常。结论:HC-NH有典型的临床表现,较为特征性的CT、MRI表现,综合考虑后可以做出明确诊断。

Objective To analyze retrospectively the CT and MRI imaging characteristics of hemichorea associated with non-ketotic hyperglycemia(HC-NH),to improve the understanding of the disease.Methods Five patients with HC-NH who were clinically diagnosed in Yiyang Central Hospital from April 2016 to November 2021 were selected.All patients underwent head CT,MRI plain scan and head magnetic resonance angiography(MRA).Results The basal ganglia were involved in all 5 cases,3 cases were left and 2 cases were right,The left legume nucleus and caudate head were involved in 2 cases,and the left putamen was involved in 1cases,the right putamen and the head of caudate nucleus were involved in 2 cases.CT scan showed high density in all 5 cases in,the lesion boundary was clear,and there was no perifocal edema and no occupancy effect.T_(1)-weighted sequence showed hyperintensity in all 5 cases,T_(2)-weighted sequence showed lower hypointense in 4 cases,isointensity in 1 case.T_(2)-FLAIR sequence showed slightly lower or inhomogeneous in all 5 cases.No abnormalities were found in 5 cases of head MRA.Conclusion HC-NH has typical clinical manifestations,characteristic CT,MRI findings,which can be clearly diagnosed after comprehensive consideration.