多模式MRI对线粒体脑肌病的诊断价值

目的探讨线粒体脑肌病多模式MRI影像学特点。方法对21例线粒体脑肌病患者的脑MRI、MRA、MRS影像资料进行分析。结果 MRI：线粒体脑肌病病灶多位于颞、枕、顶叶,病灶具有不符合脑动脉分布及游走性的特点;4例患者病灶对称性累及豆状核、丘脑和（或）尾状核;2例患者大脑、小脑、脑干萎缩,脑室增大,脑沟增宽。病灶均呈T1低信号、T2高信号,陈旧性病灶T2信号稍高;MRA：10例新发病灶处脑动脉及其远端分支较对侧相应脑动脉增粗,信号增强;MRS：14例新鲜病灶可检出倒置的乳酸双峰波及NAA/Cr降低。结论线粒体脑肌病的多模式MR影像学特点有一定的特异性,对线粒体脑肌病的诊断有一定价值。

Diagnostic value of multimode magnetic resonance imaging in mitochondrial encephalomyopathy

Objective To evaluate the multimode magnetic resonance findings imaging in mitochondrial encephalomyopathy.Methods MRI,MRA and MRS manifestations of 21 cases with mitochondrial encephalomyopathy were retrospectively analyzed.Results In 17 of the 21 cases,the lesions were mainly distributed in the cortical and subcortical zones of temporal,occipital and（or） parietal lobe.They had no definite vascular territories but tended to fluctuate.The bilateral lenticular nucleus,cerebral ganglion and（or）caudate nucleus of 4 cases were involved.The lesions were hypointensity on T1WI and hyperintensity on T2WI.Other lesions demonstrated as cerebrum,cerebellum and brainstem atrophy in 2 cases.In 10 of the 17 cases with MRA,hyperintensity was shown in cerebral arteries of fresh lesions zones.In1H-MRS,fresh lesions of 14 cases were characterized a double lactate peaks wave with decrease of NAA/Cr.Conclusion Multimode magnetic resonance image is relatively specific to mitochondrial encephalomyopathy and plays an important role in the diagnosis of mitochondrial encephalomyopathy.