摘要:
目的:分析脑皮质层状坏死(CLN)的影像学表现特点,提高诊断及鉴别诊断能力。方法:回顾性分析2015年1月至2016年11月经CT及MRI随访诊断的77例CLN患者的临床影像学资料,总结其病因及影像表现特点。77例CLN患者中男45例,女32例,年龄24~88岁(平均66.53±3.1岁)。本组均行MRI检查,71例同时行CT检查,均有3次以上影像学检查资料(平均3.8次),随访复查时间20d~18m(平均2.3月)。结果:77例中脑梗死58例,创伤性颅脑损伤9例,自发性脑出血5例,脑肿瘤术后4例,缺血缺氧性脑病1例。77例中累及双侧大脑半球者3例,单侧大脑半球病变74例。单个脑叶受累28例,两个脑叶受累35例,多个脑叶受累14例。影像学随访可见病灶侧皮层弥漫性或局灶性萎缩,皮质表面线状或沿脑回走行的CT平扫高密度及MRI T1WI高信号,部分病灶可深达基底节区或海马区。结论:CLN病因复杂多样,影像学随访中CT平扫脑皮质出现脑回状高密度影及MRI上T1WI脑回状高信号,结合临床病史可做出准确诊断。
Abstract:
Objective: To analyze the imaging features of cerebral cortical laminar necrosis(CLN), and to improve the abilities of diagnosis and differential diagnosis. Methods: From January 2015 to November 2016, 77 patients with CLN diagnosed by follow-up CT and MRI in our department were enrolled. The clinic data were analyzed retrospectively, and the etiological and imaging features were summarized. Of all the 77 patients, 45 were male and 32 were female, aged from 24 to 88 years(mean(66.53 ±3.1) years). All the patients underwent MRI examination, 71 patients also underwent CT examination, and there were more than 3 times(mean 3.8 times) imaging examination information in all the cases. The imaging examination follow-up time was 20 d ~ 18 m(mean 2.3 m). Results: Of all the 77 cases, 58 cases were cerebral infarction, 9 cases were traumatic brain injury, 5 cases were spontaneous cerebral hemorrhage, 4 cases were post-operative brain tumor, 1 case was hypoxic ischemic encephalopathy. Bilateral cerebral hemisphere involved in 3 cases, unilateral cerebral hemisphere involved in 74 cases. Single lobe involved in 28 cases, double lobes involved in 35 cases, multiple lobes involved in 14 cases. A follow-up brain imaging's demonstrated diffuse or localized cortical atrophy, with 1inear or gyrate high density on plain CT scan and high signal on MRI T1 WI, along the cortex surface or along the gyrus, some of the lesions could reach the region of basal ganglia or hippocampus. Conclusion: The etiology of CLN is complicated and diverse, typical follow-up imaging's show 1inear or gyrate high density on plain CT scan and high signal on MRI T1 WI, combined with the clinical history can make an accurate diagnosis.
百度学术
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