中毒性脑病的CT与MRI表现

CT and MRI Features of Toxic Encephalopathy

目的:分析各种中毒性脑病的CT与MRI表现。材料和方法:分析23例中毒性脑病患者的CT和MRI表现,其中7例海洛因烫吸中毒,8例CO中毒,2例工业有机溶剂中毒,6例代谢性中毒,总结其CT和MRI的诊断要点。结果:CT表现为脑白质及神经核团的对称性低密度,MRI表现为相应的长T1、长T2信号。其中基底节区发生改变的有19例,小脑齿状核的有5例,脑干有3例,丘脑有6例,发生广泛白质改变的有10例。小脑齿状核发生改变的仅限于海洛因烫吸中毒患者。结论:CT和MRI能发现脑白质及神经核团的变性和坏死改变,但各种中毒性脑病的这些改变大都不具有特异性,只是小脑齿状核的改变仅见于海洛因烫吸中毒患者。正确的诊断需认真分析影像表现,密切结合临床病史。

Purpose: To analyze the CT and MRI features of toxic encephalopathy. Materials and Methods:CT and MRI manifesitations of 23 patients with toxic encephalopathy were retrospectively analyzed.Among them,there were 7 cases with heroin vopor inhalation, 8 cases with CO inhalation,2 cases with solvents, and 6 cases with metabolic disease. Results: On CT scans, symmetrical low densities were observed in the areas of basal nuclei (n = 19) , dentate nucleus of cerebellum (n = 5), brain stem(n = 3), thalami( n = 6) and extensive white matter(n = 10) .On MRI, these lesions appeared as low signal intensity on T1 -weighted images, and high signal intensity on T2 - weightsd images. Except the dentate nucluir degenerations was only observed in cases with herion inhalation. Conclusion: CT and MRI could detect the leukoencephalopathy and the nuclei degeneration and necrosis of toxic encephalopathy, but these findings were nonspecific, except the degeneration of dentate nucleus of cerebellum in patients with heroin vapor inhalation. A correct diagnosis can be made if one combines CT and MRI findings closely with case history.