结节性硬化的MRI诊断

MRI in the Diagnosis of Tuberous Sclerosis

报导１１例脑结节性硬化并总结本病ＭＲＩ特点。材料和方法：１１例儿童结节性硬化患者。年龄５个月～１４岁。均以癫痫为主要症状就诊，８例合并皮肤病变，２例胸部和肾脏分别受累，４例智力低下。采用Ｔｏｓｈｉｂａ０．３５Ｔ超导型ＭＲＩ系统以自旋回波Ｔ１加权（Ｔ２ＷＩ）５００／２５及Ｔ２加权（Ｔ２ＷＩ）２０００／８０，横断面及矢状面平扫，层厚５－１０ｍｍ。结果：ＭＲＩ特点：（１）室管膜下结节１１例，共５５个结节，以侧脑室外侧壁分布最多５１个，第三脑室旁１个，第四脑室旁３个。Ｔ１ＷＩ上结节与脑实质呈等信号，与脑脊液形成对比，是发现室管膜下结节的最好办法。（２）皮层与皮层下结节１０例，９例分布于额顶叶，１例以脑干小脑为主，在Ｔ１ＷＩ及Ｔ２ＷＩ上结节均呈等信号，但在Ｔ２ＷＩ上结节周围有高信号环围绕（７例７０％）具诊断特征性。结论：脑结节性硬化ＭＲＩ检查中有典型征象，在本病诊断中起重要作用。

Eleven cases of tuberous sclerosis (TS) diagnosed by MRI were reported.The purpose of this study is to manifest the characteristic MRI features. Materials and Methods: 11 children suffered from TS,the age ranged from 5 months to 14 years old, with an average of 5 years old.Epilepsy was the main symptom in all cases. Skin lesions were seen in 8 cases,lung and kidney involved in 2 cases, mental retardation appeared in 4 cases. A Toshiba 0.35T superconductive MR system was used. Transaxial plane T1 and T2 weighted SE images were acquired with a head coil.Both sagital and axial scanning were performed with slice thickness of 5-10mm. Results: Characteristics of MR Imaging:1) Subependymal nodules (11 cases).A total of 55 nodules detected were as follows: 51 nodules at miscellaneous sites near the outer wall of lateral ventricule, 1 nodule along the third ventricle and 3 nodules along the fourth ventricle. .Nodules which appeared iso-intense to cerebral parenchyma on T1 WI were well-defined contrast to surrounding cerebrospinal fluid.MRI examination on T1 WI is the most valuable method for detecting subependymal nodules.2) Cortical and subcortical nodules (10 cases).9 cases appeared in frontal and parietal lobes,while 1case appeared in cerebellum and brain stem. Nodules appeared iso-intense to cerebral parenchyma on either T1 Wl or T2 WI. Characteristic hyperintense rings in 7 cases were found surrounding nodules on T2 WI. Conclusion: MRI plays an important role in characterizing TS more exactly.