Imaging Findings of Acute Bilateral Paramedian Thalamic Infarction Syndrome
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摘要: 目的:分析急性双侧中线旁丘脑梗死综合征的影像学表现特点。方法:回顾性分析我院2014年10月2017年1月经临床证实的8例急性双侧中线旁丘脑梗死综合征患者的临床和影像学资料。全部患者均于发病24 h内完成首次颅脑CT检查,5 d内完成首次颅脑MRI检查,3例有MRA检查资料。结果:首次CT检查病灶不明显3例,4例双侧中线旁丘脑可疑或小灶性低密度灶,1例双侧中线旁丘脑明确的较为对称性低密度灶。MRI均显示双侧中线旁丘脑较为对称性分布的蝶形T1WI低或略低、T2WI高或略高信号、FLAIR高或略高信号及DWI上为高信号、ADC低信号,其中以DWI高信号为特征。影像学随访中病灶进展4例。4例病程中可见中脑“V”字型梗死。3例MRA均可见单侧或双侧大脑后动脉及其分支狭窄。结论:影像学检查手段尤其是MRI,对急性双侧中线旁丘脑梗死综合征的早期诊断及鉴别诊断具有重要价值。Abstract: Objective To analyze the images features of acute bilateral paramedian thalamic infarction syndrome. Methods: From October 2014 to January 2017, 8 patients with acute bilateral paramedian thalamic infarction syndrome confirmed clinically in our hospital were enrolled, and the clinical and images data were retrospectively analyzed. All patients underwent the first CT of the brain examination within 24 h, the first MRI examination of the brain was performed within 5 d. 3 cases had MRA examination data. Results Initial CT of the brain was unremarkable in 3 cases, suspicious bilateral paramedian thalamic infarcts in 4 case (presenting as suspicious or small low-density lesions), clear bilateral paramedian thalamic infarcts in 3 cases (presenting as somewhat symmetrical low-density lesions). MRI showed that the bilateral paramedian thalamus symmetrical distribution of the butterfly low or slightly low signal in T1 WI, high or slightly high signal in T2 WI, high or slightly high signal in FLAIR, high signal in DWI, and low signal in ADC. The lesion was characterized by high signal in DWI images on MRI. Follow-up of images showed the lesion was progressing in 4 cases. "V" shaped infarction of the midbrain could be seen in the course of the disease in 4 cases. Unilateral or bilateral posterior cerebral artery and its branched vessels stenosis could be seen on the images of the three patients underwent MRA examination. Conclusion Imaging examination methods, especially MRI, are of great value in the early diagnosis and differential diagnosis of acute bilateral paramedian thalamic infarction syndrome.
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Keywords:
- thalamic infarction /
- tomography /
- X-ray computed /
- magnetic resonance imaging
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期刊类型引用(7)
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