阿尔茨海默病与血管性痴呆的胼胝体MR定量研究

目的　比较MR影像上阿尔茨海默病 (Alzheimer′sdisease ,AD)组、血管性痴呆 (vasculardementia ,VD)组、正常对照 (normalcontrol,NC)组胼胝体面积及胼胝体不同部位的厚度 ,为进一步探讨AD、VD的发病机理提供参考。方法　本研究 70例中AD 2 6例 ,VD 14例 ,年龄匹配的正常对照 3 0例。行磁共振扫描 ,取T1WI正中矢状面测量胼胝体面积及胼胝体前、前中、中、中后、后 5个部位的厚度。结果　AD组与VD组及NC组胼胝体标准化面积分别为 :(3 5 5± 0 5 2 )cm2 ;(3 48± 0 90 )cm2 ;(4 2 3± 0 43 )cm2 。AD组与VD组及NC组胼胝体前、前中、中、中后、后 5个部位标准化厚度分别为 :AD (5 3 4± 1 14)mm ,VD (5 5 3± 1 86)mm ,NC (7 0 6± 1 11)mm ;AD (2 5 3± 0 62 )mm ,VD (2 5 3±0 86)mm ,NC (3 46± 0 66)mm ;AD (2 85± 0 5 4)mm ,VD (2 84± 1 0 4)mm ,NC (3 5 4± 0 61)mm ;AD (2 0 1± 0 5 0 )mm ,VD (1 90± 0 72 )mm ,NC (2 49± 0 65 )mm ;AD (5 46± 0 96)mm ,VD (5 2 2±1 40 )mm ,NC (6 82± 1 0 2 )mm。AD组与VD组胼胝体前、前中、中、中后、后 5个部位的萎缩率分别为 :AD (2 4 3 6± 16 13 ) % ,VD (2 1 70± 2 6 3 5 ) % ;AD (2 6 75± 17 97) % ,VD (2 6 78± 2 4     

血管性痴呆的MRI研究

脑血管病是老年痴呆的重要病因,MRI可清楚地反映脑血病造成的各种病理改变,并可进一步评估它们与认知功能下降的关系。本文就脑白质疏松和脑梗死及相关脑结构改变在血管性痴呆发病中的意义作了综述。     

血管性痴呆的MRI定量研究

目的 寻找可预测血管性痴呆（ｖａｓｃｕｌａｒ ｄｅｍｅｎｔｉａ,Ｖａｌ）的神经影像学指标。方法 对３０例ＶａＤ和３０名中风后非痴呆（ｓｔｒｏｋｅ ｗｉｔｈｏｕｔ ｄｅｍｅｎｔｉａ,ＳＷＤ）患者进行ＭＲＩ测量研究,测量指标包括：大脑白质病变面积、脑梗死面积、脑室－脑比率和正中矢状面胼胝体面积与幕上颅腔面积比率,并分析脑梗死所在部位。用判别分析法寻找区分ＶａＤ与ＳＷＤ的测量指标。结果 小血管病和多发脑     

血管性痴呆的MRI研究

脑血管病是老年痴呆的重要病因.MRI可清楚地反映脑血管病造成的各种病理改变,并可进一步评估它们与认知功能下降的关系.本文就脑白质疏松和脑梗死及相关脑结构改变在血管性痴呆发病中的意义作了综述.     

血管性轻度认知障碍患者胼胝体扩散张量成像改变与认知功能的相关性研究

目的 观察胼胝体纤维束随年龄增长的变化和血管性轻度认知障碍(vMCI)患者胼胝体异常与认知功能改变的关系.方法 通过对vMCI患者(32例)、正常年老组(25例,年龄≥60岁)和年轻组(30例,年龄20~39岁)胼胝体的扩散张量成像(DTI),获得胼胝体的平均扩散(ADC)图及部分各向异性(FA)图,分别测量压部和膝部的ADC值及FA值,并对结果进行统计分析.结果 vMCI组在胼胝体膝部、压部的ADC值较年老组高,而FA值较年老组低.年老组胼胝体膝部、压部FA值均低于年轻组相应部位的FA值(P<0.05),而胼胝体膝部、压部ADC值均大于年轻组(P<0.05).vMCI组胼胝体压部的FA值与MMSE评分呈正相关(r=0.796,P<0.05),而ADC值与MMSE评分呈负相关(r=-0.803,P<0.05).结论 vMCI病人胼胝体完整性受到破坏,故胼胝体DTI的各参数变化有助于其的早期诊断.     

血管性痴呆的脑白质异常信号MR临床分析

目的：对血管性痴呆患者MR图像上的脑白质异常信号（WMH）进行体积定量测量的临床分析,并与无痴呆的脑血管病患者进行比较。方法：对18例临床诊断为血管性痴呆的患者和15例脑血管病对照患者间隔一年先后进行两次头颅MPd检查。采用自行设计的自动体积测量软件测量每位患者的初始WMH体积以及随访结束时的WMH体积变化,然后采用独立样本t检验对血管性痴呆组和对照组的初始WMH体积和咖体积变化进行比较。结果：血管性痴呆组初始WNtt体积为28269±28124n玳13,WMH体积变化为4374±4242mm3。对照组的初始WNH体积为11865±10052mm^3,WMH体积变化为1913±2574mm3。两组之间的初始WMH体积差异具有统计学意义（t=2．304,P=0．031）,而WMH体积变化则表现出有统计学意义差异的趋势（t=1．963,P=0．059）。结论：血管性痴呆患者比普通的脑血管病患者存在更加严重的白质病变,并且进展加快。WMH的增加可能认知功能的下降有关。     

老年性痴呆与血管性痴呆临床MRI对比研究

目的:比较老年性痴呆(AD)与血管性痴呆(VaD)的临床与MRI特点,寻找鉴别诊断的有效方法。方法:根据DSM-IV标准,对28例AD患者和36名VaD患者的临床和MRI进行对比分析。结果:①AD多慢性起病;VaD多急性起病,呈阶梯性病程,常伴有高血压和卒中史。②AD认知功能减退为全面广泛性,VaD认知功能减退呈部分间歇性。③AD非认知功能障碍多,常有复杂情感异常、人格主动性减退、重复收敛行为;VaD非认知功能障碍少,可有单一情感异常、人格淡漠、攻击行为。④AD躯体生活能力明显优于VaD,AD工具使用能力明显落后于VaD。⑤头颅MRI显示AD病人以广泛皮质萎缩且以双侧海马明显萎缩为主,VaD病人多为局灶异常。结论:根据临床和MRI特点可以对AD和VaD做出正确的诊断和鉴别诊断。     

非痴呆型血管性认知功能障碍的结构及功能磁共振研究进展

非痴呆性血管性认知功能障碍（VCIND）处于血管性认知功能障碍（VCI）的早期阶段,血管性认知功能障碍是由血管性因素导致的从轻度认知功能障碍到痴呆的一类综合征.已有研究表明VCIND是可以逆转的,所以对其早期干预,有着重要的社会意义.近年来,随着功能磁共振的研究与应用,对脑结构和脑网络的研究也越来越受到关注,一些磁共振新技术如磁共振扩散张量成像（DTI）和功能磁共振也应运而生,因其易操作性和无创性,且能够在体研究脑结构及脑功能方面的改变,使其越来越具有研究VCIND的生理病理机制的潜在性,本文就其在VCIND方面的研究进展进行综述.     

基于体素的形态学分析技术在评价脑灰质体积改变对皮质下缺血性血管性痴呆患者执行功能影响中的应用

目的:采用基于体素的形态学分析(VBM)技术分析皮质下缺血性血管性痴呆(SIVD)患者执行功能障碍与相关脑区灰质体积改变之间的关系.方法:分别纳入SIVD患者和健康志愿者各14例,应用VBM技术比较2组的脑灰质体积差异,分析脑灰质体积变化与执行功能的相关性.结果:与健康对照组相比,SIVD患者灰质体积显著减少,包括全脑...     

胼胝体发育不全的MRI诊断

目的 探讨MRI对胼胝体发育不全的诊断价值。方法 回顾性分析12例胼胝体发育不全的临床及MRI表现，并结合文献加以讨论。结果 MRI显示6例胼胝体完全阙如，4例部分阙如，2例变薄。结论 MRI可以直接观察胼胝体形态，是诊断胼胝体发育不全的首选方法。     

The corpus callosum in communicating and noncommunicating hydrocephalus

To investigate morphological changes in the corpus callosum in hydrocephalus and to correlate them with clinical findings we studied sagittal T2^*-weighted cine MR images of 163 patients with hydrocephalus. The height, length and cross-sectional area of the corpus callosum were measured and related to the type of cerebrospinal fluid flow anomaly and to clinical features, especially dementia. With expansion of the lateral ventricles the corpus callosum showed mainly elevation of its body and, to a lesser degree, increase in length. Upward bowing was more pronounced in noncommunicating than in communicating hydrocephalus. Dorsal impingement on the corpus callosum by the free edge of the falx correlated with the height of the corpus callosum. Cross-sectional area did not correlate with either height, length or impingement; it was, however, the strongest anatomical discriminator between demented and nondemented patients. The area of the corpus callosum was significantly smaller in patients with white matter disease. Our findings suggest that, due to its plasticity, the corpus callosum can to some degree resist distortion in hydrocephalus. Dementia, although statistically related to atrophy of the corpus callosum, is possibly more directly related to white matter disease.Dedicated to Prof. M. Nadjmi on the occasion of his sixty-fifth birthday     

Involvement of corpus callosum in amyotrophic lateral sclerosis shown by MRI

Abnormal high signal in the corticospinal tracts on MRI has been described in amyotrophic lateral sclerosis. We report a case with further high signal in fibres of the corpus callosum on proton density and T2-weighted spin-echo images, closely matching findings of earlier pathological reports.     

胼胝体胶质细胞瘤的MRI诊断

目的:探讨胼胝体胶质细胞瘤的MRI表现,提高对胼胝体胶质细胞瘤的认识。方法:对2 4例胼胝体胶质细胞瘤的MRI资料进行回顾性分析,并与病理结果作对照。结果:胼胝体胶质细胞瘤累及嘴、膝部15例,体部6例,压部3例。病理类型为星形细胞瘤18例,少支胶质细胞瘤4例,脑神经胶质瘤病2例。MRI表现为T1WI低信号、T2 WI高信号,信号均匀或不均匀,伴有水肿及占位效应,Ⅲ～Ⅳ级肿瘤多伴有坏死、囊变和出血,增强扫描根据肿瘤病理类型的不同可出现不同程度的强化。少支胶质细胞瘤伴斑片状钙化为其特征,脑神经胶质瘤病表现为多部位侵犯。胼胝体胶质细胞瘤可侵犯两侧或一侧大脑半球,形成“蝴蝶征”或“半蝴蝶征”,此二种征象有助于定位诊断。结论:胼胝体胶质细胞瘤是颅内特殊部位的肿瘤,MRI对其诊断具有重要临床价值。     

Morphological studies of the corpus callosum by MRI in children with malformative syndromes

Summary A morphological analysis of the corpus callosum has been carried out in an MRI study of 34 children with malformative syndromes and 35 normal children. We used a new morphometric method based on measurement of five specific angles. Values outside the range of normality have been found in patients with malformations of the skull, including turricephaly, acrocephaly and frontonasal dysplasia. The results have confirmed the reliability of this method for study of the conformation of the corpus callosum and of its topographical relations with the other cerebral structures.     

Classification of acquired lesions of the corpus callosum with MRI

MRI has facilitated diagnostic assessment of the corpus callosum. Diagnostic classification of solitary or multiple lesions of the corpus callosum has not attracted much attention, although signal abnormalities are not uncommon. Our aim was to identify characteristic imaging features of lesions frequently encountered in practice. We reviewed the case histories of 59 patients with lesions shown on MRI. The nature of the lesions was based on clinical features and/or long term follow-up (ischaemic 20, Virchow-Robin spaces 3, diffuse axonal injury 7, multiple sclerosis 11, hydrocephalus 5, acute disseminated encephalomyelitis 5, Marchiafava-Bignami disease 4, lymphoma 2, glioblastoma hamartoma each 1). The location in the sagittal plane, the relationship to the borders of the corpus callosum and midline and the size were documented. The 20 ischaemic lesions were asymmetrical but adjacent to the midline; the latter was involved in new or large lesions. Diffuse axonal injury commonly resulted in large lesions, which tended to be asymmetrical; the midline and borders of the corpus callosum were always involved. Lesions in MS were small, at the lower border of the corpus callosum next to the septum pellucidum, and crossed the midline asymmetrically. Acute disseminated encephalomyelitis and the other perivenous inflammatory diseases caused relatively large, asymmetrical lesions. Hydrocephalus resulted in lesions of the upper part of the corpus callosum, and mostly in its posterior two thirds; they were found in the midline. Lesions in Marchiafava-Bignami disease were large, often symmetrically in the midline in the splenium and did not reach the edge of the corpus callosum. Received: 15 October 1999 Accepted: 15 April 2000     

胼胝体梗死的MRI分析

目的 :分析胼胝体梗死的MRI表现和特征。方法 :13例胼胝体梗死患者 ,9例有高血压病史 ,4例有糖尿病 ,而同时合并有高血压及糖尿病者 3例 ,13例均行MR检查。结果 :梗死发生于胼胝体膝部者 2例 ,体部 8例 ,其中 3例为胼胝体体部多发梗死 ,1例为膝部和体部多发病灶 ,3例发生于压部 ,大小为 0 .2cm× 0 .3cm～ 1.1cm× 4.0cm。不同程度的伴有底节区、丘脑、脑干等部位的梗死。MRI上 ,T1 加权像呈低信号 ,T2 加权像上表现为高信号 ,增强扫描病灶表现为不强化或轻度不均匀强化 ,Flair序列为高信号。结论 :MRI可有效、准确、全面地显示胼胝体梗死的大小、范围以及合并的其他部位的病灶。     

Acquired lesions of the corpus callosum: MR imaging

In this pictorial review, we illustrate acquired diseases or conditions of the corpus callosum that may be found by magnetic resonance (MR) imaging of the brain, including infarction, bleeding, diffuse axonal injury, multiple sclerosis, acute disseminated encephalomyelitis, Marchiafava-Bignami disease, glioblastoma, gliomatosis cerebri, lymphoma, metastasis, germinoma, infections, metabolic diseases, transient splenial lesion, dilated Virchow-Robin spaces, wallerian degeneration after hemispheric damage and focal splenial gliosis. MR imaging is useful for the detection and differential diagnosis of corpus callosal lesions. Due to the anatomical shape and location of the corpus callosum, both coronal and sagittal fluid-attenuated inversion recovery images are most useful for visualizing lesions of this structure.     

胼胝体病变分布特点的MRI分析

目的 :总结各类胼胝体病变的MRI影像分布特点。方法 :68例经证实并行MRI检查的各种胼胝体病变按是否仅局限在胼胝体 ,横轴面上胼胝体区病灶是否按中线分布 ,胼胝体病灶的前后位置 ,胼胝体外脑内病灶是否左右对称分别分组 ,分析各种病变分布上有无特点。结果 :① 68例病变中 17例局限于胼胝体 ,5 1例合并胼胝体外脑内病灶。②胼胝体区病灶 5 6例为中线分布 ,12例为偏侧分布。③ 7例脑轴索损伤 ( 7/11) ,6例肾上腺脑白质营养不良 ( 6/6) ,3例脂肪栓塞 ( 3 /3 ) ,4例海洛因脑病 ( 4/4 ) ,1例病毒性脑炎 ( 1/2 )累及胼胝体压部。 6例胶质母细胞瘤 ( 6/10 )累及胼胝体前部。④非局限组中 3 6例 ( 3 6/5 1)脑内病灶为对称和基本对称分布。结论 :各种胼胝体病变的影像分布有明显的特征性     

可逆性胼胝体压部病变综合征的磁共振成像诊断及预后评估

目的探讨可逆性胼胝体压部病变综合征的磁共振成像(MRI),分析其预后。方法回顾性分析2014年1月至2017年12月经我院诊断的50例可逆性胼胝体压部病变综合征的MRI影像学资料,分析患者的影像学特征。结果MRI诊断表现胼胝体压部孤立性,圆形或弧形,少数为斑片状,边界清晰。4例T1WI信号改变不明显,其余患者T1WI呈等或稍低信号,T2WI呈稍高信号,FLAIR为稍高信号,信号均匀,病变周围水肿和占位效应不明显,44例T1WI增强扫描病灶无明显强化特征;DWI呈明显高信号且表现扩散系数(ADC)呈低信号;5例行磁敏感加权成像(SWI)检查,4例行MRS检查,5例行MRA检查,结果未见异常特征;3例行扩散张量成像(DTI)检查显示各向异性分数(FA)值减低。45例复查MRI表现为胼胝体压部病变完全消失,无神经系统受累症状,预后效果好;3例DWI信号欠均匀,中央区见稍低信号,预后较差;1例随访发现患有严重神经系统后遗症,四肢无自主运动,长期卧床,预后不良。结论MRI能为RESLES临床诊断提供重要依据,结合其临床症状,为临床诊治提供重要参考依据,一般预后良好。     

Atrophy of the corpus callosum correlates with white matter lesions in patients with cerebral ischaemia

Many studies of white matter high signal (WMHS) on T2-weighted MRI have disclosed that it is related to cerebral ischaemia and to brain atrophy. Atrophy of the corpus callosum (CC) has also been studied in relation to ischaemia. Our objective was to test the hypothesis that CC atrophy could be due to ischaemia. We therefore assessed CC, WMHS and brain atrophy in patients with risk factors without strokes (the risk factor group) and in those with infarcts (the infarct group), to investigate the relationships between these factors. We studied 30 patients in the infarct group, 14 in the risk factor group, and 29 normal subjects. Using axial T1-weighted MRI, cortical atrophy and ventricular enlargement (brain atrophy) were visually rated. Using axial T2-weighted MRI, WMHS was assessed in three categories: periventricular symmetrical, periventricular asymmetrical and subcortical. Using the mid-sagittal T1-weighted image, the CC was measured in its anterior, posterior, midanterior and midposterior portions. In the normal group, no correlations were noted between parameters. In the infarct group, there were significant correlations between CC and brain atrophy, and between CC atrophy and WMHS. After removing the effects of age, gender and brain atrophy, significant correlations were noted between some CC measures and subcortical WMHS. In the risk factor group, there were significant correlations between CC and brain atrophy and between CC atrophy and WMHS. After allowance for age, gender and brain atrophy, significant correlations between some CC measures and periventricular WMHS remained. The hypothesis that CC atrophy could be due to cerebral ischaemia was supported by other analyses. Namely, for correlations between the extent of infarcts and partial CC atrophy in patients with anterior middle cerebral artery (MCA) and with posterior MCA infarcts, there were significant correlations between the extent of infarct and midanterior CC atrophy in the former, and posterior CC atrophy in the latter. Our findings could indicate that CC atrophy is associated with cerebral ischaemia. Received: 5 December 1998/Accepted: 6 November 1999