Imaging Manifestation of Cerebral Cortical Laminar Necrosis

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.