肝豆状核变性的颅脑MRI表现及相关分析

目的总结肝豆状核变性患者颅脑MRI特征,探讨MRI在肝豆状核变性诊断中的价值。方法对临床和生化证实的13例肝豆状核变性患者进行脑部MRI检查。结果 13例肝豆状核变性患者颅脑MRI特征为基底节区、丘脑、脑干等对称性异常信号。结论肝豆状核变性临床表现多样,颅脑MRI检查对本病诊断有重要意义。     

一家族4例脑型肝豆状核变性的MRI诊断

目的 探讨肝豆状核变性的脑部MRI表现及其临床应用价值。方法 对一家族4例经临床化验证实的肝豆状核变性患者的脑部MRI表现进行分析。结果 患者脑部MRI主要改变为铜沉积所致的继发性双侧大致对称性的长T1长T2信号,增强无强化;发病部位依次为壳核4例,苍白球4例,丘脑3例,尾核头2例,齿状核1例,中脑1例,出现脑萎缩3例。结论 肝豆状核变性脑部改变以继发为主,MRI表现有一定的特征性,且与临床症状有一定的相关性。     

低场磁共振（MRI）在脑型肝豆状核变性中的临床应用

目的分析肝豆状核变性脑部MRI表现,探讨低场中MRI在脑型肝豆状核变性中的临床应用价值。方法回顾性分析9例经临床及实验室检查确诊的肝豆状核变性病例的脑部MRI表现。结果脑部MRI异常信号在豆状核头部及壳核出现5例,丘脑出现2例,同时累及尾状核头部、壳核、丘脑、小脑齿状核及脑干2例;主要表现为铜沉积所致的继发性双侧大致对称性的长T1、长T2信号,在FLAIR上呈高信号,增强无强化。结论肝豆状核变性脑部改变以继发为主,MRI表现有一定的特征性,且与临床症状有一定的相关性;MRI对肝豆状核变性的诊断及预后有重要价值。     

肝豆状核变性颅脑MRI表现与临床相关分析简

目的研究肝豆状核变性的MRI影像特点及与临床症状的关系。方法13例经临床及化验证实的肝豆状核变性患者,男性8例,女性5例,均行头颅MR检查。结朵病范围较广泛,多集中于基底节、丘脑及脑千,异常信号为对称分布,T1WI呈低信号或等信号,T2WI多表现为高信号或稍高信号,2例豆状核T2WI高信号中央出现片状低信号。三倒有轻度脑萎缩表现。结论MRI可清晰显示肝豆状核变性脑部病变,有助于肝豆状核变性的临床诊断,且病变程度与临床表现相关。     

肝豆状核变性颅脑MRI表现与临床相关分析

目的研究肝豆状核变性的MRI影像特点及与临床症状的关系。方法 13例经临床及化验证实的肝豆状核变性患者,男性8例,女性5例,均行头颅MR检查。结果病范围较广泛,多集中于基底节、丘脑及脑干,异常信号为对称分布,T1WI呈低信号或等信号,T2WI多表现为高信号或稍高信号,2例豆状核T2WI高信号中央出现片状低信号。三例有轻度脑萎缩表现。结论 MRI可清晰显示肝豆状核变性脑部病变,有助于肝豆状核变性的临床诊断,且病变程度与临床表现相关。     

Wilson病的脑部MRI表现与临床相关性分析

目的：探讨肝豆状核变性（wilson病）在脑部MRI表现及临床研究。方法：对10例经临床及实验室检查证实的肝豆状核变性患者进行脑部MRI检查,对结果进行分析。结果：发病部位豆状核80％,丘脑50％,脑桥40％,尾状核60％。结论：wilson病脑部MRI改变多为铜沉积所致的继发性的基底节对称性的长T2长T1信号,MR表现与临床症状有一定相关性。     

肝豆状核变性87例脑核磁共振成像表现特点分析

目的探讨核磁共振成像（MRI）在肝豆状核变性中的诊断价值。方法收集87例肝豆状核变性MRI结果,并进行分析。结果87例中脑部MRI出现异常信号66例（75．9％）,分布频率最高的是豆状核（59例,89．4％）,其次是丘脑、大脑脚、桥脑等部位;15例经治疗后复查有12例异常信号范围变小或消失。结论脑部MRI是肝豆状核变性诊断的有力佐证,MRI检查可作为确诊和评估疗效的有效手段。     

MRI在获得性肝性脑部变性诊断中的应用

目的研究MRI在获得性肝性脑部变性（AHCD）诊断中的价值。方法回顾性分析8例行MPd头部扫描的获得性肝性脑部变性患者的MRI表现及临床资料。结果8例患者MRI扫描均见TlWI呈对称性高信号,双侧苍白球8例、豆状核4例、中脑红核周围5例、垂体前叶1例;T2WI及FLAIR未见明显异常信号。结论双侧苍白球、豆状核、中脑红核周围、垂体前叶等部位出现的对称性TIWI高信号是获得性肝性脑部变性比较特异性的征象。MRI对获得性肝性脑部变性的诊断具有重要价值。     

肝豆状核变性脑磁共振成像及氢质子磁共振波谱表现

目的探讨肝豆状核变性脑磁共振成像(MRI)及磁共振氢质子波谱(1H-MRS)表现特点,为早期诊断和治疗提供依据。方法回顾性分析经临床和实验室证实26例肝豆状核变性患者的脑部MRI及9例患者的1H-MRS表现,其中,男性17例,女性9例,年龄6~44岁;所有患者均行头颅MRI平扫检查;9例患者行1H-MRS检查。结果26例患者脑部MRI检查,呈长T₁长T₂信号22例,稍短T₁短T₂信号1例,混杂长T₁混杂长T₂信号3例,病灶典型者依受累部位不同,分别表现为“八字”征、“展翅蝴蝶”征;病灶位于豆状核26例,尾状核16例,丘脑12例,中脑9例,桥脑5例,齿状核4例,额叶白质区2例,颞叶1例,12例患者有不同程度的脑萎缩;9例患者行1H-MRS分析,选取38个体素,18个体素置于双侧豆状核,6个体素置于尾状核头部,9个体素置于丘脑,3个体素置于桥脑,2个体素置于额叶。其中22个体素胆碱化合物(Cho)升高,17个体素肌酸(Cr)下降,20个体素区N-乙酰天门冬氨酸(NAA)下降。结论肝豆状核变性的MRI及1H-MRS表现具有一定的特征性,MRI及1H-MRS对肝豆状核变性早期诊断及治疗提供有力依据,并了解不同病程时期,指导临床治疗,评价其治疗效果均有独特的临床作用。     

肝豆状核变性脑部CT诊断与分析

目的 探讨肝豆状核变性的CT表现特点。方法 对6例经临床及化验证实的肝豆状核变性的脑部CT进行分析。结果 发病部位主要分布于基底节区，苍白球、壳核、丘脑，呈对称分布的略低密度影。结论 CT是发现并诊断肝豆状核变性的重要手段。     

Diffusion-weighted magnetic resonance imaging in diagnosis of Creutzfeldt-Jakob disease

Background Creutzfeldt-Jakob disease （CJD）, a rare disease, is uncharacterized by computed tomography （CT） and magnetic resonance imaging （MRI）. This study was aimed to evaluate the diffusion-weighted MRI （DWI） manifestations of CJD and to discuss their diagnostic value. Methods The findings of T1-weighted MR/（T1WI）, T2-weighted MRI（T2WI）, DWI and post-contrast MRI in 5 patients （3 patients with biopsy-proven CJD and 2 patients with clinically-proven CJD） were retrospectively analyzed in this study. Results Four out of the 5 patients had cerebral atrophy of various degrees. One patient showed symmetric high signal intensity at the bilateral globus pallidus and the head of the caudate nucleus, with very high signal in the cerebral cortex on the DWI. This patient only had symmetric slightly high signal at the bilateral globus pallidus and putamen on T2WI. One patient had high signal intensity at the basal ganglia and cerebral cortex on DWI, but abnormal T2 signal intensity at the bilateral paraventricular white matter on MRI. Two patients presented with widely gyri-like high signal intensity at the cortex on DWI, but routine MRI showed bilateral paraventricular long T2 signal intensity in 1 patient and no abnormal findings in another. No abnormalities were shown by both routine MRIand DWI in the last patient. Conclusions DWI is more sensitive than its conventional counterpart in the depiction of CJD. DWI is more sensitive to detect cortical abnormal signal intensity in CJD not detected by T2WI.     

磁敏感加权成像诊断阿尔茨海默病的Meta分析

目的利用Meta分析的方法评价磁敏感加权成像(SWI)在阿尔茨海默病(AD)诊断中的价值,为临床及科研决策提供依据。方法计算机检索Pubmed、CNKI、WanFang Data、VIP数据库相关文献,查找有关应用SWI量化AD脑铁沉积的病例对照试验,并追溯纳入文献的参考文献。对纳入文献进行资料提取和评估方法学质量后,采用RevMan 5.3软件进行Meta分析。结果最终纳入8项研究,共420例受试者。Meta分析结果显示:AD组与正常对照组相位值的总体效应检验差异在黑质、海马、尾状核头、左侧红核、额叶皮层、苍白球及壳核[WMD值、95%CI及P值分别为-0.07(-0.09,-0.06),P0.00001;-0.03(-0.04,-0.02),P0.00001;-0.03(-0.05,-0.02),P0.00001;-0.04(-0.06,-0.01),P=0.01;-0.02(-0.02,-0.01),P0.00001;-0.05(-0.06,-0.04),P0.00001;-0.04(-0.06,-0.03),P0.00001]具有统计学意义,SWI测量以上各ROIs相位值对于AD诊断具有较高的临床及科研价值。结论 Meta分析提示SWI测量黑质、海马、尾状核头、左侧红核、额叶皮层、苍白球及壳核相位值在AD组和对照组间有统计学差异,而这一差异可能有助于诊断AD。     

弥散张量成像技术研究抽动秽语综合征患儿基底节及丘脑微小结构异常

目的 运用弥散张量成像(DTI)技术观察首发未用药抽动秽语综合征(tourette's syndrome,TS)患儿基底节及丘脑结构的完整性.方法 本研究纳入13例TS患者,以及10例正常对照.DTI扫描采用具有15个弥散梯度方向的单次激发平面回波序列.经DTIStudio软件计算出每个受试者的平均表观弥散系数(ADC)图和分量各向异性参数(FA)图,然后采用手动勾画感兴趣区(ROI)的方法,用ROIEditor软件在平均弥散加权(aDWI)图像上画出双侧尾状核、壳核、苍白球和丘脑,提取上述区域的FA值和平均ADC值进行组间比较.结果 与正常对照儿童相比,TS患儿左侧苍白球和双侧丘脑FA值降低(P<0.05);双侧尾状核、双侧壳核和双侧丘脑的ADC值增高(P<0.05);左侧丘脑的FA值降低与症状评分相关(r=0.77,P<0.05).结论 运用DTI技术发现TS患者基底节和丘脑组织微观结构异常,尤其是左侧丘脑的异常,提示丘脑在TS病理生理机制中具有重要作用.     

肝豆状核变性患者中文书写时皮质下结构的功能影像研究

目的 通过观察脑型肝豆状核变性患者中文字词书写的皮质下结构激活特点,为基底神经节在书写中的作用机制提供实验数据.方法 将7例脑型肝豆状核变性患者分成正常书写组和书写障碍组,分别进行假写作业、中文字词书写作业的18氟脱氧葡萄糖(18F-fluorodeoxyglucose,18F-FDG)脑功能成像,用统计参数图软件(SPM2)得出基底神经节变化区域.结果 正常书写组的皮质下结构激活区包括双侧苍白球和右侧壳核,书写障碍组包括右侧丘脑腹外侧核、屏状核和左侧壳核、苍白球,均差异有显著性(P<0.01).结论 1)脑型肝豆状核变性患者的中文书写涉及双侧基底神经节,右侧基底神经节可能发挥更重要的作用.2)伴有书写障碍的肝豆状核变性患者双侧基底神经节激活点与正常书写的患者比较存在较大差异,右侧丘脑的激活对受损的书写功能可能有代偿作用.     

肝性脑病的临床与MRI诊断

目的：研究获得性肝性脑部变性的MRI特征。方法：收集经临床确诊的获得性肝性脑部变性20例,其中男性13例,女性7例。全部病例均有完备的临床与MRI资料。结果：20例脑部均有阳性MRI表现,其中双侧、豆状核20例,苍白球17例,中脑红核周围15例,垂体前叶4例,表现为自旋回波（SE）序列T1WI为高信号,T2WI及FLAIR像无异常。结论：获得性肝性脑部变性的MRI征象具有特征性,MRI对该病的诊断有较高价值。     

Comparative study of the sectional slice of the anterior commissure and the internal capsule with its MRI images

Objective:The brain of 100 normal persons were performed MRI scan and image analysis.12adult female brain specimens fixed by formalin,were made into the thickness of 0.5mm by celloidin embedding technique.We analyzed the anatomical position of the relationship about the anterior limb of internal capsule and the anterior commissure in eollodion-embedded plans,and then compared with the brain MRI of normal people.We also further compared the statistical differences of the internal capsule’s volume.This research aimed to provide a reliable sectional anatomic basis for the study of the central nervous system and deep brain stimulation to treat the mental neurological diseases.Results:1.Continous observation of celloid in brain slices horizontal section:Approximately 130 slices of each specimen,from the parietal lobe,the internal capsule was the typical structure"><"on the level of about 35 mm.On the level of about 41mm,the anterior commissure was"arc"through the bottom head of the caudate nucleus connecting the bilateral anterior limb,which located between the caudate nucleus and the lentiform nucleus.The posterior limb of internal capsule situated between the dorsal thalamus and the lentiform nucleus on the level of about 46 mm.Coronal section:about 150 slices of per specimen,from the former lateral ventricle horn back,on the level of about 16 mm the anterior commissure was"arch"connecting the anterior limb.About 28 mm dimension,the interior capsule fore limb located between the caudate nucleus and the putamen,the posterior limb of internal capsule located between the globus pallidus and the dorsal thalamus,extending down to the cerebral peduncle.Sagittal section:about 180 slices of per specimen,from the outside to the inside at the beginning of the temporal lobe,the corona radia taextends between the putamen and dorsal thalamus,and then formsthe posterior limb of the internal capsule at the level of about 21 mm.About 25 mm level,fore limb located between the caudate nucleus and the putamen;Genu of the internal capsule located between the caudate nucleus and dorsal thalamus;the posterior limb of internal capsule located between the putamen and the dorsal thalamus,and then extends to the brain stem.2.The observation of brain MRI images horizontal position:Above the typical level of the internal capsule,internal capsule showed high signal,and the boundaries could be still recognized.Below the typical levels of the internal capsule,the globus pallidus and the anterior limb of the internal capsule showed low signal intensity,and both ill-defined,but we could still identify the boundaries of the internal capsule fore limbs.Coronal position:Before the globus pallidus appeared,the tomography of collodion brain slices and brain MRI images were basically the same form.MRI images could be observed clearly that the anterior commissure connected the bilateral the anterior limbs.Sagittal position:The corona radiata was not observed in the MRI images,and thento switch toward the internal capsule.The emergence of dorsal thalamus and globus pallidus boundaries were not observed clearly.3.Three dimensional reconstruction and analysis of the measurement results The anatomical structural features of the internal capsule and adjacent structures could be continuously,multi-directionally and then dynamically observedon the horizontal,coronal and sagittal plane by three dimensional reconstruction.The anatomical localization of the posterior limb of the internal capsule can be clearly observed in the sagittal plane.The volume data of the left and right internal capsule was statistically significant.Conclusions:1.The experiment described anatomical localization and the three-dimensional model of the internal capsule and anterior commissure in detail,and to provide a reliable basis for the functional anatomy relations between the two follow-up studies.2.Comparing continuous thin brain slices with the corresponding section of the brain MRI images study,the brain slices collodion show much more clearly than the MRI image about the positional relationship between the internalcapsule and adjacent structures.3.Measurements of the internal capsule and its various divisions on the left and right were statistically significant to provide data support for the asymmetry of brain morphology study.     

急性一氧化碳中毒后迟发性脑病的临床表现、CT及MRI

目的：探讨急性一氧化碳中毒后迟发性脑病（DEACMP）患者的头部CT及磁共振成像（MRI）改变的特点和诊断价值。方法：分析20例DEACMP患者的临床表现、CT及MRI资料。结果：DEACMP患者的主要临床表现为智能、人格改变;关部CT的特征表现为双侧大脑白质弥漫性低密度改变,以两侧或单侧基底节区或苍白球区低密度改变最明显;MRI表现为脑室 周围白质和半卵圆中心双侧对称的点状、斑片状或融合性病灶,T2加权呈高信号,T1加权呈低信号,基底节或苍白球区呈慢性缺血性改变。偶见病灶主要位于大脑皮层。结论：本病的诊断主要依靠病史、临床表现和影像学检查。头部MRI对本病的诊断、鉴别诊断明显优于CT。     

R2?鄢值评价健康成年人脑铁含量与年龄的相关性研究

目的  采用3.0T增强梯度回波T2?鄢加权血管成像（ESWAN）定量测量健康成年人额叶白质区及灰质核团的R2?鄢值,探讨额叶白质区及灰质核团与年龄的相关性。方法  收集20～85岁的157例健康成年人进行MRI常规及磁敏感加权成像（SWI）扫描,按其年龄段分为6组：A组20～29岁,B组30～39岁,C组40～49岁,D组50～59岁,E组60～69岁,F组≥70岁。经后处理在R2?鄢图像上分别测量双侧额叶白质区、红核、黑质网状带、黑质致密带、尾状核头、壳核、苍白球和丘脑的R2?鄢值,分析R2?鄢值与年龄的相关性。结果  健康成年人在黑质网状带、苍白球的R2?鄢值最低,额叶白质区的R2?鄢值最高。其中黑质网状带、壳核、苍白球、丘脑和尾状核头的R2?鄢值在部分年龄段比较,差异有统计学意义（P <0.05）,有一定规律性。而红核、黑质致密带、额叶白质区的R2?鄢值在不同年龄段比较,差异无统计学意义（P >0.05）。红核、黑质网状部、壳核、苍白球、尾状核头的R2?鄢值与年龄呈正相关（r =0.188、0.269、0.524、0.347和0.407,P <0.05）,丘脑的R2?鄢值与年龄呈负相关（r = -0.317,P =0.000）,而黑质致密部、额叶白质区的R2?鄢值与年龄无关（P >0.05）。结论  SWI能清晰显示脑内核团的结构,准确评估脑内的铁含量和随年龄变化的规律。