桥脑中央髓鞘溶解的MRI诊断(附2例分析)

目的:探讨桥脑中央髓鞘溶解症(central pontine Myelinolysis CPM)的MRI特征。方法:分析CPM患者的MRI表现,总结了CPM的最佳MR影像诊断与鉴别诊断要点。结果:MRI表现为:(1)病灶位于桥脑上部;(2)T1WI病灶呈低或略低信号强度,T2WI呈高信号或略高信号;(3)静脉注入GD-DTPA后,病灶中央呈明显均匀强化,及轻度强化,边缘清晰锐利。结论:MRI是CPM的最好检查方法,当有上述表现时高度提示CPM的可能。

Diagnoses of central pontine myelinolysis with MR imaging : Analysis in two cases

Purpose: To explore the MR imaging features of central pontine myelinolysis and to assess their enhancement characteristics on Gd - DTPA enhanced MR imaging . Methods: Two patients with central pontine myelinolysis underwent 3 - dimensional scan MR imaging before and after intravenous administration of Gd - DTPA . Features on MR imaging were analyzed and optimal program of MR imaging diagnosis and differential diagnosis of this disease was discussed. Results: Characteristic findings on MR imaging were: (1) The lesions located in upper area of the pontine; (2) On T1WI the lesions were hypointense or slight hypointense signal , whereas on T2WI the lesions were hyperintense or slight hyperintense signal; on MR imaging obtained after intravenous administration of Gd - DTPA the central area of the lesions were homogeneous enhancement or slight enhancement but its borders were clear and sharp. Conclusions: When above findings are found on MR imaging the diagnosis of central pontine myelinolysis is easely to do out. In our opinion, MR imaging is now the best method used to diagnose This desease and should be prefered in clinical