肠道病毒71型感染手足口病合并脑炎的MRI表现及特征

目的探讨肠道病毒71型感染手足口病合并脑炎的MR表现及特征,为临床诊断及及时治疗提供帮助。方法回顾性分析2009年4月～2011年7月临床诊断为手足口病合并脑炎并行颅脑MR扫描的64例患儿的图像资料,所有病例均经病原学检查证实为肠道病毒71型感染。结果脑干病变共计32例,其中桥脑6例(主要位于桥脑背侧),延髓8例(6例表现为延髓背侧对称性小片状信号,2例为偏中心病灶),桥脑-延髓交界区8例,中脑10例(多位于双侧大脑脚,呈片状);小脑齿状核4例(双侧);丘脑4例(均为单侧丘脑,斑点状或小片状);右侧内囊后肢1例(呈条形);基底节区9例(多为斑点状信号);放射冠区、半卵圆中心及双侧额、顶叶皮质下区者共38例(病变多为多发斑点状信号);其中病灶位于单个部位者35例(35/64,54.69%),位于多个部位者29例(29/64,45.31%)。结论手足口病合并脑炎发病部位广泛,不只局限于脑干,基底节、内囊后肢、丘脑、小脑齿状核及双侧大脑白质区均可累及。总结其易发病部位,依次为脑干、脑白质、基底节、丘脑、小脑齿状核,MR颅脑扫描能真实、准确显示手足口病合并脑炎脑部受损情况,可为临床诊断及时治疗提供可靠的影像学依据。     

特发性甲状旁腺功能减退的脑CT表现(附13例分析)

目的：探讨特发性甲状旁腺功能减退的脑CT表现。方法：回顾分析13例患者的临床特征和CT表现。结果：13例均有基底节和大脑叶钙化，其中对称性大脑叶钙化10例，对称性基底节区钙化9例，丘脑钙化8例，中脑钙化3例，小脑齿状核钙化7例，全部病例内囊均不受累。结论：基底节或／和大脑叶对称性钙化是特发性甲状旁腺功能减退的特征性CT表现。     

甲状旁腺功能减退脑部CT表现

目的 探讨甲状旁腺功能减退的临床表现及脑部影像学表现.方法 回顾分析16例甲状旁腺功能减退患者的临床特征和颅脑CT表现.结果 16例患者有不同程度的脑内钙质沉着.CT表现为两侧(豆状核及尾状核)钙化10例,丘脑钙化4例,额叶、顶叶、枕叶和颞叶内对称性或不对称性分布的斑点状、斑片状、条带状或半环状多发的不规则高密度钙化4例.在头部CT扫描片上,两侧小脑半球、大脑半球和基底节区的脑内钙质沉着也可更加广泛.结论 癫痫和癫痫发作性晕厥可能与钙的脑内沉着有关.颅脑CT对原发性甲状旁腺功能减退脑内钙质沉着的诊断与鉴别诊断很有价值.     

甲状旁腺功能减退症头颅CT表现

目的 进一步认识甲状旁腺功能减退症的头颅CT特征，以提高CT诊断的准确性。方法 回顾分析16例临床确诊甲状旁腺功能减退症的临床，实验室检查及CT资料，其中继发性7例，特发性9例，均行CT平扫，结果 16例均显示脑实质钙化。苍白球钙化见于16例，尾状核头钙化16例尾状核体钙化10例。豆状核钙化13例。壳核钙化12例。齿状核钙化12例，丘脑钙化8例，顶叶钙化11例，额叶钙化10例，枕叶钙化8例。颞叶钙化4例。钙化基本呈双侧对称性。结论 甲状旁腺功能减退症CT表现具有一定特征性，CT对病变程度的判定有一定价值，但明确定性则需结合临床特征及实验室检查。     

颅脑CT在甲状旁腺机能减退诊断中的价值分析

目的分析甲状旁腺机能减退的颅脑CT表现，提高对本病的认识，减少误诊、误治。方法对经临床确诊的甲状旁腺机能减退21例病例进行颅脑CT平扫，将CT扫描结果进行分析。结果21例均发现脑内不同程度钙化，钙化呈多发性、对称性、多形性，钙化大都分布在基底节区、小脑、丘脑、皮质-髓交界区，而内囊区未累及，钙化灶的数目、大小与病程成正相关。结论甲状旁腺机能减退症的颅脑CT表现具有特征性，可为临床诊断提供可靠的客观依据，结合低血钙、高血磷、甲状旁腺激素水平降低即可诊断。     

特发性甲状旁腺机能减退症的脑CT表现与临床症状对照分析(附12例分析)

目的:探讨特发性甲状旁腺功能减退症的脑CT表现及临床特征的相关性.方法:回顾性分析12例特发性甲状旁腺功能减退患者的CT表现,并与相应临床症状对照研究.结果:12例均发生对称性基底节钙化,此外,小脑齿状核钙化6例,丘脑钙化6例,大脑半球钙化6例,12例内囊均无受累.患者病程1、2、3年以及3年以上者分别为3、4、3、2例,随着病程延长,脑内钙化部位逐渐增多.4例有癫痫发作均见基底节钙化之外的其它部位的脑钙化.结论:以基底节对称性钙化为主的脑内多部位钙化是特发性甲状旁腺功能减退的特征性CT表现.脑内钙化范围与临床病程及症状有关.     

扩散加权成像在正常胎儿脑发育中的应用

目的 探讨扩散加权成像(DWI)对正常胎儿脑发育的评估价值.方法 回顾性分析40例正常胎儿脑DWI表现,孕周19～39周,平均33.6周.在ADC图上分析总结正常胎儿脑表现特征,并测量脑干、双侧小脑半球、基底节区、丘脑、颞叶白质、额叶白质、枕叶白质、半卵圆中心及顶叶白质的ADC值,分析不同部位ADC值随孕周变化的规律.结果 在ADC图上,胎儿幕上脑实质表现为信号强度不同的分层状结构,随孕周增加分层减少.双侧大脑半球间对称部位ADC值无显著性差异.幕上深部白质平均ADC值高于小脑半球、脑干及深部灰质核团,顶叶ADC值最高(1.62 ±0.17) mm/s,脑干ADC值最低(1.08±0.13) mm/s.胎儿脑干、双侧小脑半球、基底节区、丘脑、颞叶白质、枕叶白质、半卵圆中心及顶叶白质ADC值与胎龄呈负相关,小脑半球相关系数最高(r=0.78),枕叶相关系数最低(r=0.38),额叶与胎龄无线性相关(P＞0.05).小脑半球ADC值随胎龄增长下降最快(b=0.03).结论 DWI可应用于正常胎儿脑发育的评估,为胎儿脑发育的产前诊断及预后提供重要信息.     

颅脑CT诊断甲状旁腺功能减退的价值：附14例报告

本文报道了甲状旁腺功能减退，低血钙，高血磷四肢抽搐１４例。ＣＴ表现：基底节，小脑齿状核，丘脑，尾状核，脑干及脑皮质与髓质之间对称性钙化。本文对甲旁减临床表现，病因，病理进行了讨论。     

皮层下动脉硬化性脑病的CT 诊断分析

目的：探讨皮层下动脉硬化性脑病的C T应用价值。方法对72例皮层下动脉硬化性脑病患者C T检查资料进行了回顾性分析。结果所有患者均见两侧脑室前后角、体旁脑白质、半卵圆中心对称出现的带状、小片状或融合呈现大片状低密度影,边缘呈月晕状,部分低密度区可相互融合,无占位表现,病变长轴与侧脑室体部一致,灰白质界限清晰。多为对称分布,病灶模糊不清,脑灰白质交界线尚可分清,本组病例中位于侧脑室体旁52例,占72．22％。侧脑室前角周围36例,占50．00％。侧脑室后角周围29例,占40．28％。半卵圆中心脑白质区40例,占55．56％。位于额叶、枕叶及顶叶皮质下34例,占47．22％。伴有基底节区、丘脑区及放射冠区腔隙性脑梗塞或脑软化44例,占61．11％,其中位于基底节区28例,丘脑区7例,放射冠区9例。结论皮层下动脉硬化性脑病的C T表现有显著特点。     

家族性Fahr综合征1例报告

Fahr综合征是以双侧纹状体-苍白球-齿状核钙化(BSPDC)为主要表现的罕见疾病,主要应与甲状旁腺功能减退症相鉴别。现报告1例家族性Fahr综合征的诊治经过。     

CT and MR evaluation of intracranial involvement in pediatric HIV infection: a clinical-imaging correlation.

PURPOSE: To review the cranial CT and MR examinations of 29 children with perinatally transmitted HIV infection and correlate the imaging findings with clinical and pathologic data. METHODS: 28 children were examined with CT, four with MR. RESULTS: CT abnormalities were seen in 25 children studied (89%), including cerebral atrophy (25 children), basal ganglia calcification (10 children), periventricular frontal white matter calcification (four children), cerebellar calcification (one child), white matter low attenuation areas (two children), intracranial hemorrhage (three children) and cerebral infarction (one child). Intracranial calcifications were only seen in association with cerebral atrophy and were never seen prior to 1 year of age. Calcifications in the periventricular white matter or cerebellum were always associated with basal ganglia calcifications. MR abnormalities were seen in all four children studied; cerebral atrophy (four children), areas of high signal intensity in white matter (four children), loss of normal posterior pituitary high signal intensity (one child). Cerebral atrophy appeared to be a nonspecific finding that was seen in some children in the absence of neurologic signs and symptoms. All children with intracranial calcifications had developmental delay. Intracranial hemorrhage was seen in children with severe thrombocytopenia. Focal intracranial infections were unusual and neoplastic lesions were not found. CONCLUSIONS: Cerebral atrophy, basal ganglia calcifications, and focal white matter lesions were the most common abnormalities seen neuroradiologically in our series of HIV-infected children; cerebral atrophy was a nonspecific finding.     

Prevalences of CT-detected calcification in the basal ganglia in idiophathic hypoparathyroidism and pseudohypoparathyroidism

Summary Sixteen patients with idiopathic hypoparathyroidism (IHP) and eight patients with pseudohypoparathyroidism (PHP) were examined by CT scan of the brain. Calcification in the basal ganglia was observed in 11 patients with IHP (69%) and in all eight patients with PHP. Of the 19 patients with basal ganglia calcification, nine had calcification in the cerebral cortex (47%), and four had calcification in the cerebellum (21%). Observation of basal ganglia calcification on CT gave rise to suspicion of IHP or PHP in three patients (12%). The remaining patients were examined at varying time after diagnosis. Since arrest in growth of calcification after institution of treatment has never been proven, the reported prevalences of calcification may not be valid to the situation at the time of diagnosis.     

老年人皮质下动脉硬化性脑病的病理学基础和CT,MRI对照研究

本文就２６例皮质下动脉硬化性脑病患者的ＣＴ、ＭＲＩ检查结合病理学基础进行了分析。ＭＲＩ检查，当ＴＲ＝２０００ｍｓｅｅ，ＴＥ＝３０、６０ｍｓｅｃ时，皮质动脉硬化性脑病损害均为明显的高信号，Ｔ１加权像为低信号。ＣＴ像为低密度改变。Ｔ２加权像上半卵圆中心的白质表现为不均匀弥漫的高信号区，可累及基底节、丘脑、脑干及小脑的白质，并有不同程度的侧脑室扩大、脑室边缘呈斑片状改变可有脑萎缩。病理学特征是弥漫不完全     

MR imaging of optic pathways in patients with neurofibromatosis

Twenty-one patients with documented neurofibromatosis had MR examinations to evaluate possible intracranial disease. In five cases the indication was a known or suspected optic glioma. Two patients were examined because of a history of seizures; the rest were examined as part of a baseline evaluation. Eighteen patients showed evidence of signal hyperintensity on T2-weighted images. Lesions involved the optic nerves, optic chiasm, optic tracts, lateral geniculate body, optic radiations, basal ganglia, periventricular white matter, cerebellar white matter, and dentate nucleus of the cerebellum. Comparison between MR and concurrent CT scans showed MR to be superior in demonstrating the posterior extent of optic-pathway gliomas. In addition, MR showed focal areas of hyperintensity in the basal ganglia, internal capsule, cerebellum, and/or white matter that were not detected on CT. Although we found MR to be superior to CT in detecting intracranial tumors in patients with neurofibromatosis, and in evaluating the extensive involvement of known lesions, the full clinical implications of our findings remain to be determined.     

A morphometric CT study of Down's syndrome showing small posterior fossa and calcification of basal ganglia

Summary We report characteristic and morphometric changes of cranial computed tomography (CT) with increasing age in 56 patients with Down's syndrome aged from 0 month to 37 years. Patients were compared with 142 normal controls aged 0 to 59 years. Width of ventricles, Sylvian fissures, posterior fossa, pons and cisterna magna were measured on CT. The incidences of the cavum septi pellucidi, cavum vergae and cavum veli interpositi and high density in the basal ganglia were examined. There was high incidence (10.7%) of bilateral calcification of basal ganglia in Down's syndrome, although that of pineal body and choroid plexus calcification was similar in Down's syndrome and controls. Basal ganglia calcification is more frequently seen in young Down's syndrome and may be related to the premature aging characteristic of Down's syndrome. The CT in Down's syndrome showed relatively small posterior fossa, small cerebellum, small brain stem and relatively large Sylvian fissures in those under one year of age. There was a high frequency of midline cava and large cisterna magna. There were no significant atrophic changes on CT except after the fifth decade comparing with controls.     

MR imaging in Fahr disease

The calcifications of Fahr disease that are detected by CT in the dentate nuclei of the cerebellum, basal ganglia, and white matter of the cerebral hemispheres displayed three patterns with magnetic resonance imaging using the multiple echo technique: (a) cerebellar calcifications were undetected; (b) basal ganglia calcifications displayed low or no signal and appeared as "black" areas in four echoes; and (c) white matter calcifications displayed a high signal in the four echoes and appeared intensely white. The different behavior of the three calcified sites probably reflects different stages of the disease or different metabolic states with predominance of inert calcium deposits in the basal ganglia. In the white matter there is probably a higher concentration of binding proteins and mucopolysaccharides.     

特发性甲状旁腺机能减退症颅脑CT及MRI表现

目的探讨颅脑CT及MRI检查对特发性甲状旁腺机能减退症(IHP)的诊断价值。方法回顾性分析16例经临床确诊的IHP患者头颅CT(16/16)和MRI(3/16)表现,观察病变的范围和密度/信号等特点。结果IHP颅内主要表现为多发钙化性病变,在CT上表现为高密度,CT值114～373HU,在MRT1WI呈稍高信号或高信号,T2WI呈等信号。双侧尾状核、苍白球、壳核及丘脑的对称性、条形或团块状钙化16例;双侧额、颞、顶、枕叶皮层下钙化10例;小脑齿状核钙化6例(双侧4例,单侧2例);侧脑室旁钙化2例。结论CT和MR对IHP的诊断非常重要,其中CT对病变的显示优于MR,与临床结果结合,对IHP具有定性诊断意义。     

Akute disseminierte Enzephalomyelitis

Acute disseminated encephalomyelitis (ADEM) is an acute widespread autoimmune demyelinating condition, which principally affects the white matter of the brain and spinal cord. It usually follows an infection or vaccination. The typical presentation is that of multifocal neurologic disturbances accompanied by change in mental status. CSF analysis reveals lymphocytic pleocytosis and elevated protein content, but may also yield normal results. MRI is regarded as the diagnostic imaging modality of choice and typically demonstrates involvement of deep cerebral hemispheric and subcortical white matter as well as lesions in the basal ganglia, gray-white junction, diencephalon, brainstem, cerebellum and spinal cord. Unlike multiple sclerosis (MS), ADEM has a monophasic course and a favorable long-term prognosis.