橄榄桥脑小脑萎缩的临床表现及MR诊断价值

目的 探讨橄榄桥脑小脑萎缩（OPCA）的临床表现及其在MR影像表现上的特征性.方法 回顾性分析8例OPCA患者（OPCA组）的临床及MR表现.另选择75例健康体检者作为对照组,按年龄分为21 ～ 30岁组、31 ～ 40岁组,41～50岁组,51 ～ 60岁组,61 ～ 70岁组,每组15例,对所有研究对象均进行桥脑测量.结果 8例OPCA患者均为散发病例,临床以小脑症状、植物神经症状及锥体外系症状多见.头颅MR表现为小脑和脑干萎缩,特征性表现为“十字征”.OPCA组患者桥脑的上下径和前后径分别为（20.63±2.16）和（16.74±4.37） mm,与对照组（27.14±1.73）和（22.28±1.49） mm]比较差异有统计学意义（P＜0.01）.对照组中在21 ～30岁组和31～ 40岁组桥脑上下径及前后径数值最大,随着年龄增大数值有所减小,但差异无统计学意义（P＞0.05）.结论 MR是诊断OPCA的首选检查方法,结合临床表现可以提高OPCA的诊断准确率.

The clinical manifestations of olivopontocerebellar atrophy and the diagnostic value of MR

Objective To investigate the clinical manifestations and MR imaging features of olivopontocerebellar atrophy（OPCA）.Methods The clinical data and MR findings of 8 patients with OPCA （OPCA group） were retrospectively analyzed,and 75 cases of healthy physical examination people were chosen as control group （they were divided into 21-30 years group,31-40 years group,41-50 years group,51-60 years group,61-70 years group,and 15 cases in each group）,all subjects under went pons measurement.Results All 8 patients with OPCA were sporadic cases.The cerebellar symptom,autonomic symptoms and extrapyramidal symptoms were common manifestations.The head MR imaging of OPCA presented with cerebellum and brain stem atrophy,＂cross sign＂ was the characteristic appearance.Vertical diameter and anteroposterior diameter of the pons in OPCA group patients was （20.63 ± 2.16） and （16.74 ±4.37） mm,compared with control group （27.14 ±1.73） and （22.28 ± 1.49） mm],there was significant difference （P 〈 0.01）.In control group,vertical diameter and anteroposterior diameter of the pons maximum in 21-30 years group and 31-40 years group,increased with age,the value had been reduced,but there was no significant difference （P 〉 0.05）.Conclusion MR is the first choice for the diagnosis of OPCA,combine with clinical manifestations may improve the diagnostic accuracy.