急性CO中毒迟发性脑病的MRI表现

目的：探讨急性CO中毒迟发性脑病（DEACMP）的MRI特征。方法：回顾性分析21例急性CO中毒迟发性脑病患者的MRI和临床资料。结果：急性CO中毒迟发性脑病MRI表现可分为3种：①神经核团受累：21例,典型表现为双侧苍白球对称性的长T1、长T2信号;②脑白质受累：11例,表现为双侧大脑半球白质对称云絮状长T1、长T2信号,胼胝体常受累;③皮层受累：6例,表现为双侧大脑半球皮层对称性弥漫长T1、长T2信号。结论：急性CO中毒迟发性脑病MRI表现有一定特征性,MRI对急性CO中毒迟发性脑病的诊断、鉴别诊断、判断预后具有重要价值。     

一氧化碳中毒迟发性脑病的MRI表现

目的:研究一氧化碳(CO)中毒迟发性脑病的MRI特征.方法:回顾性分析32例CO中毒迟发性脑病患者的MRI和临床资料.结果:CO中毒迟发性脑病MRI表现可分为三型:①神经核团受累型;②脑白质受累型;③皮层受累型.MRI特征:苍白球为对称性的卵圆形长T1、长T2信号,皮层下白质为对称性的弥漫、模糊云雾状长T1、长T2信号,侧脑室周围、半卵圆中心白质亦为对称云絮状长T1、长T2信号,胼胝体常受累.MRI显示苍白球合并脑白质受累者及皮层受累者,临床表现较重.结论:CO中毒迟发性脑病MRI表现有一定特征性,且能反应其病理过程,并对CO中毒迟发性脑病的诊断和评价临床表现、预后均有意义.     

急性一氧化碳中毒迟发性脑病的MRI诊断

目的 探讨急性一氧化碳中毒迟发性脑病的MRI表现，提高对该病的正确诊断率。资料与方法 总结和分析临床证实的19例急性一氧化碳中毒迟发性脑病的MRI表现。结果 (1)脑白质异常信号7例，主要分布于侧脑室旁的脑白质及半卵圆中心，为大片状长T1、长T2信号，呈对称分布。(2)苍白球斑点状异常信号4例，其中3例为双侧苍白球对称性长T1、长T2信号，1例为右侧苍白球短T1、长T2信号并左侧黑质点状长T1、长L信号。(3)侧脑室旁脑白质及半卵圆中心对称长T1、长T2信号并基底节异常信号8例。有7例并双侧苍白球异常信号，3例为长T1、长T2信号，4例为短T1、长T2信号；1例并右侧内囊及左侧尾状核头部短T1、长T2信号。结论 MRI是诊断急性一氧化碳中毒迟发性脑病的最佳影像学检查方法。     

一氧化碳中毒脑损伤的CT、MRI研究

目的　评估CO中毒脑损伤的CT、MRI表现并比较其发现病变的能力。方法　对 5 2例CO中毒脑损伤患者行CT、MRI扫描 ,分析比较CT、MRI所见。结果　CT诊断苍白球变性坏死 9例 ,脑白质脱髓鞘 3例 ,脑萎缩 3例。CT的阳性检出为 15例 ,阳性率 2 8.8%。MRI诊断苍白球变性坏死 2 4例 ,脑白质改变 10例 ,其中苍白球变性伴脑白质脱髓鞘 7例 ,海马区改变 8例。MRI的阳性检出为3 1例 ,阳性率为 5 9.6% ,MRI的阳性率高于CT。 2组检出率对比有显著性差异。结论　CT、MRI对CO中毒脑损伤诊断均有意义。MRI对CO中毒诊断优于CT ,MRI能显示比CT更多的病变     

磁共振弥散加权成像对急性一氧化碳中毒的诊断价值

目的 :评价磁共振弥散加权成像对急性一氧化碳中毒的诊断价值。方法 :回顾性分析 6例急性一氧化碳中毒的MRI表现 ,分别采用SE序列T1WI、T2 WI、FLAIR和DWI。结果 :急性一氧化碳中毒MRI表现为两侧大脑皮层、皮层下区及苍白球T1WI等信号、T2 WI高信号 ,所有异常信号均呈两侧对称性改变。结论 :磁共振弥散加权成像对急性一氧化碳中毒具有重要诊断价值。     

放射性脑损伤的MRI分析

目的：分析放射性脑损伤的MRI表现及MRI诊断的意义。方法：回顾性分析25例放射性脑损伤患者的MRI资料,观察并比较病变的部位、范围及增强表现。结果：急性放射性脑损伤1例,深部脑白质及胼胝体压部对称性长T2信号,脑白质和胼胝体压部肿胀,增强扫描无强化;早期迟发性放射性脑损伤18例,深部脑白质对称性长T2信号,增强扫描无强化;晚期迟发性放射性脑损伤6例,双侧颞叶不均匀长T1长T2信号,增强扫描呈明显花环样强化。结论：放射性脑损伤具有特征性MRI表现,MRI对诊断放射性脑损伤具有重要价值。     

新生儿胆红素脑病脑损伤的MRI诊断价值

目的 :探讨新生儿胆红素脑病(NBE)脑损伤的MRI诊断及应用价值。方法 :回顾性分析45例NBE患儿头部MRI表现及临床资料。结果:45例中33例颅脑MRI表现为双侧苍白球区对称性T1WI高信号,17例T1WI高信号同时累及底丘脑或丘脑腹外侧;T2WI均呈等信号,T2FLAIR呈等或稍高信号;DWI均未见明显异常信号改变。12例1~3个月随访复查颅脑MRI,4例T2WI呈对称性稍高信号,临床上有脑损伤后遗症改变;8例颅脑MRI检查未见明显异常,临床上也未见明显神经异常症状。结论:新生儿NBE颅脑MRI苍白球区有特征性表现,即急性期为苍白球对称性T1WI高信号,慢性期为对称性T2WI稍高信号,可为临床早期诊断及预后判断提供帮助。     

火药燃烧致群体一氧化碳中毒的影像学表现及分析

目的：探讨火药燃烧致急性一氧化碳中毒肺、脑损伤的影像学表现．以提高诊断水平。方法：对37例一氧化碳中毒患者行胸部X线、头颅MRI检杏，并分析其影像学表现特点。结果：①急性肺损伤8例，表现为肺纹理增强、肺门浓密和肺部大片状阴影；②脑部损伤6例，表现为对称性海马、苍白球信号异常。结论：肺、脑是急性一氧化碳中毒极易受损的器官，肺损伤以肺水肿改变为主，脑损伤以海马、苍白球水肿、缺血、坏死改变为主。     

有机磷中毒性脑病恢复期MRI表现(附4例报告)

目的:探讨有机磷中毒性脑病恢复期的MRI特征.方法:回顾性分析4例重度有机磷中毒慢性期脑结构变化.结果:双侧巴宾斯基征阳性4例,脑电图轻度异常4例.1例右侧小脑半球和中脑长T1长T2信号.1例双侧尾状核和壳核对称性长T2信号,T1WI高信号.1例双侧尾状核、壳核和苍白球对称性长T1长T2信号,侧脑室扩大,小脑萎缩.1例双侧尾状核、壳核和苍白球对称性异常信号,T1WI部分萎缩的小脑回呈高信号;脑室扩大,双侧枕叶内侧回、脑干和小脑萎缩.结论:有机磷中毒性脑病恢复期MRI表现主要累及尾状核、苍白球、丘脑、中脑和小脑;严重者皮质出现软化灶,伴有脑萎缩.     

基底节区异常信号的MRI鉴别诊断及临床价值

目的：探讨以基底节区异常信号为主要表现的疾病的MRI征象及鉴别诊断价值。方法：回顾性分析22例经临床证实的以基底节区异常信号为主要表现的疾病的MRI资料。结果：发生部位：苍白球9例,壳核17例,尾状核头部12例,合并双侧丘脑4例、脑干6例。肝豆状核变性4例;感染3例;中毒7例,其中CO中毒5例,霉变甘蔗中毒1例,糖尿病药物诱发的乳酸中毒1例;维生素B1缺乏性脑病1例;缺氧缺血损害7例,其中脑梗死4例,HIE 3例。信号特征：肝豆状核变性MRIT1WI等或稍低信号,T2WI高信号;感染、维生素B1缺乏性脑病、脑梗死、新生儿缺氧缺血性脑病,T1WI呈低信号,T2WI呈高信号;CO中毒4例及霉变甘蔗中毒1例表现为T1WI等、低信号,T2WI均为高信号,CO中毒1例及糖尿病药物诱发的乳酸中毒1例,表现为T1WI高信号,T2WI等信号;5例增强后病灶均有明显强化。脑梗死为非对称性分布,其余皆为对称性分布。结论：以基底节区异常信号为主要表现的疾病的MRI有一定的特征性,结合临床不难鉴别。     

The magnetic resonance imaging appearances of the brain in acute carbon monoxide poisoning

AIMS: To describe the magnetic resonance imaging (MRI) appearances of the brain in acute carbon monoxide poisoning, the commonest cause of accidental poisoning in Europe and the U.S.A. To attempt to correlate the imaging findings with patient outcome as an aid to prognosis. MATERIALS AND METHODS: Brain MRI was performed on 19 consecutive patients, who had sustained acute carbon monoxide poisoning, as soon as possible after their referral to the regional Hyperbaric Unit at the Royal Hospital, Haslar. All patients were unconscious on arrival, and had received at least one treatment with hyperbaric oxygen by the time of first MR. The imaging findings were analysed independently by two experienced MR radiologists, with a third radiologist arbitrating on discrepant results. RESULTS: Thirteen male and six female patients, age range 21-70 years (mean 38.7 years) underwent MR an average of 35.6 h (range 6-126 h) following presentation at the referring centre. MR (at 0.5T) revealed abnormalities in the following areas: globus pallidus (n = 12); other basal ganglia [ n = 5: entire lentiform (globus pallidus and putamen), putamen alone, caudate nucleus, thalamus]; white matter (n = 6: periventricular, subcortical, other); cerebral cortex (n = 5), either localized or general; medial temporal lobe in the region of the hippocampus (n = 4). The majority of the patients with hyperintensity in the region of the hippocampus (n = 3) had no other area of cortical involvement. Two patients showed abnormalities in the cerebellum. Normal appearances were seen on the initial MR in seven patients. CONCLUSION: The appearances of the brain following acute CO poisoning are varied, and have previously been the subject of case reports or small studies, most of which have have addressed the delayed sequelae of this condition. This study, the first large series undertaken in the acute phase, confirms that, although the globus pallidus is the commonest site of abnormality in the brain, the effects of CO poisoning are widespread. The extent of damage correlates with clinical outcome, and therefore aids management and prognosis.     

Cerebellar lesions in the acute setting of carbon monoxide poisoning

Bilateral globus pallidus and supratentorial white matter injury are common findings in the acute and chronic setting of carbon monoxide (CO) poisoning. However, isolated cerebellar lesions are extremely rare. In this case report, we shared our findings in siblings with cerebellar injury with different imaging patterns in the acute setting of CO poisoning.     

Basal ganglia volumes following CO poisoning: A prospective longitudinal study.

Carbon monoxide (CO) poisoning may result in focal and diffuse neuropathological changes, including basal ganglia lesions. The effect of CO poisoning on basal ganglia volumes over time is unclear. We assessed basal ganglia volumes longitudinally following CO poisoning. We prospectively enrolled 73 CO poisoned patients who underwent brain MR imaging on day 1 (baseline), 2 weeks, and 6 months post-CO poisoning. Basal ganglia volumes were obtained. One patient had bilateral globus pallidus lesions at two weeks and 6 months. Of the CO-poisoned patients 28% had volume reduction in at least one basal ganglia structure by 6 months, of which 21% had putamen, 15% had caudate, 15% had globus pallidus, and 16% had total basal ganglia volume reduction. Putamen volumes were significantly smaller from baseline to six months (p = 0.02). Verbal memory and mental processing speed correlated with smaller putamen and globus pallidus volumes. Carbon monoxide poisoning results in basal ganglia volume reduction 6 months post CO poisoning. Slow mental processing speed and impaired memory correlated with smaller putamen and globus pallidus volumes. Clinicians need to be aware of basal ganglia neuropathologic changes in the absence of observable lesions following CO poisoning.     

急性一氧化碳中毒的颅脑CT观察(附100例分析)

分析了100例急性一氧化碳中毒及迟发脑病患者的颅脑CT改变。在未出现迟发脑病68例(A组)及出现迟发脑病的32例(B组)中,各有28例发现颅脑CT异常,异常率分别为41.2％、87.5％。两组CT异常主要表现为双侧大脑皮层下白质及苍白球或内囊大致对称的密度减低区,后期出现脑室扩大或脑沟增宽。对CT改变与病理特点、昏迷时间、检查时间,以及与神经系统症状体征间的关系进行了分析与讨论,指出颅脑CT对重度急性CO中毒及迟发脑病具有辅助定位诊断与鉴别诊断、判断病情及预后的作用。     

盐酸法舒地尔联合高压氧对急性CO中毒患者治疗的影响

目的 研究盐酸法舒地尔联合高压氧治疗急性CO中毒患者外周血NO、超氧化物歧化酶（superoxide dismutase,SOD）及磁共振成像（magnetic resonance imaging,MRI）表现变化。方法 本研究采取前瞻性研究,收集2019年10月-2021年1月在达州市中心医院急诊科进行诊断并治疗的CO中毒患者120例作为研究对象,随机分为观察组和对照组,每组患者60例。对照组患者均采取常规治疗合并高压氧治疗,观察组患者在此基础上联合采取盐酸法舒地尔联合治疗,两组患者均治疗2周。比较两组患者的治疗效果、外周血NO、SOD水平、头颅MRI扫描结果以及并发症之间的差异。结果 观察组（91.67%）患者的总有效率优于对照组（75.00%）;经过治疗后,两组患者的外周血NO、SOD水平均升高,且观察组患者的外周血NO、SOD水平高于对照组;两组患者的双侧苍白球异常、弥漫性脑肿胀以及皮质白质的云团状改变情况降低,且观察组患者的双侧苍白球异常、弥漫性脑肿胀以及皮质白质的云团状改变情况低于对照组,差异具有统计学意义（P<0.05）。两组患者的并发症之间的差异无统计学意义（P>0.05）。结论 急性CO中毒患者采用盐酸法舒地尔联合高压氧治疗,患者的外周血NO、SOD得到改善,MRI脑组织损伤情况改善,治疗效果较好,建议临床推广。     

MRI在新生儿急性胆红素脑病诊断中的价值

目的:探讨T1WI信号强度在新生儿急性胆红素脑病诊断中的价值。方法:对59例皮肤黄染新生儿行颅脑MRI检查,根据血总胆红素水平分为组Ⅰ、Ⅱ、Ⅲ、Ⅳ,测量并比较4组间双侧苍白球T1WI、T2WI信号强度。结果:①肉眼观察,组Ⅳ中6例患儿左、右侧苍白球T1WI信号明显升高,T2WI信号强度无明显差异。②经统计学分析,各组左、右侧苍白球T1WI信号强度差异无统计学意义(P>0.05),组Ⅳ双侧苍白球T1WI信号强度测量值较其余各组明显增高(P<0.05);组Ⅲ双侧苍白球T1WI信号强度测量值较组Ⅰ、Ⅱ明显增高(P<0.05);组Ⅰ、组Ⅱ之间差异无统计学意义(P>0.05)。4组间苍白球T2WI信号强度、eADC、ADC值差异无统计学意义(P>0.05)。结论:苍白球T1WI对称性信号增高是新生儿急性胆红素脑病的重要特征,并与血清胆红素水平密切相关。