脑皮质组织形成异常的MRI、^1H-MRSI和DTI的初步研究

MRI, Proton MR Spectroscopic Imaging and Diffusion Tensor Imaging of Malformations of Cortical Organization:Initial Experience

目的 总结常见皮质组织形成异常的 3DT1WI薄层扫描及曲面重建、2D MRSI、DTI的表现 ,探讨新的MRI检查方法对其应用。方法 收集 4例皮质组织形成异常的病例 ,其中 1例多小脑回 ,3例脑裂畸形 ;分析其 3D重T1WI薄层扫描、2D MRSI、DTI的改变 ,并与正常对照组比较。结果 ① 3D重T1WI薄层扫描多平面曲面重建可以多角度细微地显示病变的部位以及脑回的形态 ;② 4例病变中有 3例Cho/NAA较正常对照组增高 ,1例正常 ,3例各向异性增加、1例无改变 ;3例扩散无变化、1例增加。DTI显示 1例病人MRI表现正常的白质束异常。结论 各种新的MR技术对研究皮质组织形成异常有很大的作用 ,皮质组织形成异常表现多样且有超出常规MRI所显示的广泛的脑功能的异常。

Purpose To perform the MRI, proton MR spectroscopic imaging and diffusion tensor imaging in malformations of cortical organization and to have a better understanding of advanced MR technology in malformations of cortical organization. Methods The findings of four patients with malformations of cortical organization (3 schizencephalic lesions and 1 polymicrogyria) were studied and 10 controls in 3D heavily T1WI and curved reconstructions, 2D-MRSI and DTI were retrospectively reviewed. Results ①3D heavily T1WI and curved reconstructions can provide a good basis for reconstructions in any required plane and was useful for accurate assessment of the gyral pattern. ②Areas of increased fraction anisotropy were in 3 patients and increased diffusivity in 1. Changes in tissue beyond the malformations of cortical organization that appeared normal on conventional MRI were found in 1 patient. Conclusion The advanced MR technology was very useful in malformations of cortical organization. Abnormalities in patients with malformations of cortical organization exceeded the apparently focal abnormality shown by MRI indicating widespread abnormalities of cerebral function.