一氧化碳中毒迟发性脑病患者MRI图像特征分析

Analysis MRI Image Features of Patients with Carbon Monoxide Poisoning Delayed Encephalopathy

目的:分析一氧化碳(CO)中毒迟发性脑病(DEACMP)患者MRI图像特征。方法:选取2019年7月—2022年3月丰县人民医院收治的20例DEACMP患者作为研究对象,分析其MRI图像特征。结果:20例患者病变主要累及双侧侧脑室旁大脑白质(13例)、基底节区(双侧苍白球为主,呈对称性,5例)、大脑皮质(2例)。依据急性脑损伤分类标准,分为3种损伤类型:苍白球病变4例,弥漫性对称病变14例,不对称局灶性病变2例。首次行MRI检查,病灶均呈T1WI低、T2WI及FLAIR高信号,DWI高信号,ADC低或中等信号。复查MRI,3例可见脑室旁白质病灶,2个月内呈进展趋势,2个月后复查病灶均缩小,且DWI信号正常;余17例复查MRI,病灶均有缩小趋势。结论:MRI可用于观察DEACMP患者颅内病变的动态变化情况,并与其他病变鉴别。

Objective:To analyze the MRI image features of patients with delayed encephalopathy after carbon monoxide(CO)poisoning(DEACMP).Methods:A total of 20 DEACMP patients admitted to Feng Xian People's Hospital from July 2019 to March 2022 were selected as the study subjects.Their MRI image features were analyzed.Results:The lesions in 20 patients mainly involved bilateral periventricular white matter(n=13),basal ganglia(predominant on bilateral globus pallidus,symmetric,n=5)and cerebral cortex(n=2).According to the classification criteria of acute brain injury,they were divided into three types of injury:globus pallidus lesions in 4 cases,diffuse symmetric lesions in 14 cases,and asymmetric focal lesions in 2 cases.On the first MRI examination,the lesions showed low signal intensity on T_1WI,high signal intensity on T_(2WI) and FLAIR,high signal intensity on DWI,and low or medium signal intensity on ADC.MRI reexamination showed the lesions of periventricular white matter in 3cases,which showed a progressive trend within two months.Two months later,the lesions decreased,and the DWI signal was normal;while the lesions in the remaining 17 cases showed a decreasing trend on MRI reexamination.Conclusion:MRI can be used to observe the dynamic changes of intracranial lesions in DEACMP patients.