作者单位:471003洛阳,河南科技大学第一附属医院神经内科(连立飞黄丽娜),磁共振室(孙聚葆倪莉);华中科技大学同济医学院病理学系(李杜娟);首都医科大学北京宣武医院神经内科(贾建平)低血糖脑病的影像学特征连立飞李杜娟孙聚葆黄丽娜倪莉贾建平【摘要】目的探讨低血糖脑病的影像学特征。方法回顾性分析7例低血糖脑病患者的核磁共振资料。结果低血糖脑损害有高度的区域选择性,可不对称。主要累及大脑皮层、海马、基底节和胼胝体压部,甚至皮层下白质;MRI表现为等或稍长T1、长T2信号,DWI呈高信号,伴ADC值降低,部分病变可逆;MRS示病变区乳酸峰无明显变化。结论低血糖脑损害有很强的区域选择性、可不对称;DWI对病变更敏感;大脑皮层和基底节区受累者预后不佳,侵犯胼胝体压部者预后好。【关键词】低血糖脑病核磁共振成像弥散加权成像【中图分类号】R742R816.1【文献标识码】A【文章编号】1007-0478(2009)06-0331-04NeuroimagingfeaturesofhypoglycemicencephalopathyLianLifei＊,LiDujuan,SunJubao,etal.＊De-partmentofNeurology,theFirstAffiliatedHospitalofHenanUniversityofScienceandTechnology,Luoyang471003【Abstract】ObjectiveToinvestigatetheneuroimagingfeaturesofhypoglycemicencephalopathy(HE).MethodsThemagneticresonanceimagesof7patientswithHEwereanalyzedretrospectively.ResultsMRimagesrevealedspecificlesionsinHE,whichwasasymmetryandreversibe.Therewereisointenseorhypoin-tenseabnormalitiesonT1-weightedimagesandhyperintenseabnormalitiesonT2-weightedanddiffusion-weightedimagesinthecerebralcortex,hippocampus,basalganglia,thespleniumofcorpuscallosum,andeventhesubcorticalwhitematter,sparingthethalamusandcerebellum.DWIshowedtheareasofinvolvementatanearliertimebetterthanconventionalMRI,withthereducedapparentdiffusioncoefficient.MRspectroscopyre-vealednoevidenceofabnormallactateintheaffectedcerebralcortex.ConclusionsMRIcanshowhighlyselec-tivelesionsinHE,whichareasymmetryandreversibe.DWIcanbemoresensitivethanconventionalMRIindetectingthelesions.Lesionsofthebasalgangliaandcerebralcortexareoftenwithapooroutcome,andinvolv-mentinthespleniumofcorpuscallosummaybewithgoodoutcome.【Keywords】MagneticresonanceimagingDiffusion-weightedimagingHypoglycemicencephalopathy...
