线粒体脑肌病综合影像表现

目的:探讨多种影像技术对线粒体脑肌病(ME)的诊断价值.方法:回顾性分析7例线粒体脑肌病患者的影像资料,其中7例行常规MRI扫描,3例行MRA扫描,4例行MRS扫描,1例行DSA检查,6例行CT平扫.结果:6例病变主要累及两侧大脑皮层和皮层下,1例主要表现为白质内改变,均表现为长T1、长T2改变;MRA示2例未见明显改变,1例示病变处血管分支明显增粗;4例MRS在病变处检出乳酸双峰,1例在脑脊液中检出乳酸双峰.1例行DSA检查示病灶内血管分支增粗,血运加快.6例行CT检查病灶均呈低密度改变.结论:影像检查尤其是MRI检查对ME的诊断提供了丰富的信息,当年青患者出现非典型性脑梗死表现,MRS检出乳酸双峰时要考虑到线粒体脑肌病的可能.

Preliminary Analysis on the Integrated Imaging Appearances of Mitochondrial Encephalomyopathy

Objective:To evaluate the role of application of multiple imaging modalities in the diagnosis of patients with mitochondrial encephalomyopathy(ME).Methods:Clinical and imaging findings of 7 cases of patients with ME were retrospectively analyzed.All of the 7 patients were studied with regular MRI,3 patients were scanned with MRA,4 patients were examined with MRS,1 patient was studied with DSA and 6 patients were examined with CT.Results:In 6 of the 7 cases,the lesions were mainly found in the cortical and subcortical zones of the brain,while in the other one case lesions were mostly seen in white matters.All of the lesions appeared as long T1 and T2 foci.No significant abnormal findings were shown in 2 of the 3 cases examined with MRA,whereas,dilated vessel branches were noticed within lesions in the other 1 case.In all of the 4 cases scanned with MRS,double peaks of lactate were detected,and double lactate peaks were found in cerebral spinal fluid in 1 of the 4 cases.Dilated vessel branches with accelerated blood flow in lesions were revealed in the case examined with DSA.In the 6 cases scanned with CT,all the lesions appeared as low density foci.Conclusion:Imaging examinations,especially MR imaging,provided much and valuable diagnostic information of ME.In case that atypical symptoms and signs of brain infarction accompanying with double lactate peaks on MR spectroscopic images were found in a young patient,the diagnosis of mitochondrial encephalomyopathy should be highly considered.