多系统萎缩的临床和CT、MRI特点

Clinical, CT and MRI characteristics of patients with multiple system atrophy

目的 了解多系统萎缩(multiple system atrophy,MSA)患者的临床基本特征及CT和MRI的特点。方法 回顾性地分析了1994年～2001年大连医科大学附属二院神经科40例MSA患者的临床资料、CT和MRI资料和随访结果。结果 MSA平均发病年龄为52.2±6.8岁,男性占70％,女性占30％;患者多为慢性发病、进行性加重,对美多巴治疗无明显效果。神经系统症状复杂,头颅CT和MRI可见脑干、小脑萎缩,环池及四脑室扩大。结论 MSA临床以自主神经症状、锥体外系、小脑性共济失调为主,CT和MRI主要表现脑干、小脑萎缩,环池及四脑室扩大,但MRI较CT敏感度更高。

Objective To investigate the fundamental clinical, CT and MRI characteristics of 40 cases with MSA. Methods The clinical data, CT.MRI and followed-up data of 40 patients with MSA from 1994 to 2001 were retrospectively analyzed. Results The mean onset ages of patients with MSA were 52. 2±6. 8 years old. 70% of the patients were male, 30% wsre female. The onset of the disease was slow and their symptoms progressed. There was no evident improvement after Madopar treatment. Neurological symptoms were complicated. CT and MRl scan could find brain stem and cerebellar atrophy, and circular cistern and the forth ventricle enlargement. Conclusion The main neurological symptoms of MSA are focus on autonomic nervous system, extrapyrami-dal motor system and cerebellar ataxia. CT and MRI scan can find brain stem and cerebellar atrophy, and circular cistern and the forth ventricle enlargement, but MRI findings are more sensitive than CT.