海洛因所致海绵状白质脑病的影像学表现

目的阐述吸食海洛因所致海绵状白质脑病的影像学表现及CT、MR的诊断价值。方法搜集15例具有吸食海洛因病史患者的CT与MR影像资料。其中12例患者进行了MR检查，检查序列包括T1WI、TWI，FLAIR序列；6例进行了CT横断面检查。结果（1）MR表现：12例患者中，双侧幕上半球脑白质、小脑半球、内囊后肢和膝部及胼胝体压部表现为对称性均匀或不均匀的长T1低信号、长T2高信号病变，小脑齿状核形态信号正常。其中4例患者中脑中央可见椭圆形长T1、长T2信号影。（2）CT表现：双侧幕上半球、小脑半球、内囊后肢及膝部均见对称性、沿白质分布的低密度4例。双侧小脑半球类圆形，双侧内囊后肢条形对称性低密度伴左侧放射冠区多发斑片状低密度1例。双侧内囊后肢和膝部、胼胝体膝部及双侧幕上半球脑白质密度对称性减低1例。结论吸食海洛因所致海绵状白质脑病具有典型的影像学表现，MR较CT更能揭示病变的特征，高压氧治疗有助于病情缓解。

Imaging characteristics of spongiform leukoencephalopathy induced by heroin

Objective To elucidate the imaging characteristics of spongiform leukoencephalopathy induced by heroin and the diagnostic value of MRI and CT examinations. Methods The CT and MRI datas of 15 cases with heroin addictive history were collected, among which 12 cases were examined by MR, the sequences include T1WI, T2WI and FLAIR, and 6 cases were examined by CT. Results Bilateral symmetrical lesions were found to be located in cerebral, cerebellar white-matter, internal capsule and callosum in almost all cases. CT showed these lesions were hypodensities which were hypointensities in T1WI imaging, hyperintensities in T2 WI imaging. Cerebellar white-matter was suffered more severely, but the dentate nucleus was not invaded. Conclusion Heroin-induced spongiform leukoencephalopathy has characteristic patterns in MRI and CT,and MRI can show them more accurately than CT does. Hyperbaric oxygen therapy is helpful for alleviating the symptoms.