急性一氧化碳中毒迟发性脑病的MRI诊断

目的 探讨急性一氧化碳中毒迟发性脑病的MRI表现，提高对该病的正确诊断率。资料与方法 总结和分析临床证实的19例急性一氧化碳中毒迟发性脑病的MRI表现。结果 (1)脑白质异常信号7例，主要分布于侧脑室旁的脑白质及半卵圆中心，为大片状长T1、长T2信号，呈对称分布。(2)苍白球斑点状异常信号4例，其中3例为双侧苍白球对称性长T1、长T2信号，1例为右侧苍白球短T1、长T2信号并左侧黑质点状长T1、长L信号。(3)侧脑室旁脑白质及半卵圆中心对称长T1、长T2信号并基底节异常信号8例。有7例并双侧苍白球异常信号，3例为长T1、长T2信号，4例为短T1、长T2信号；1例并右侧内囊及左侧尾状核头部短T1、长T2信号。结论 MRI是诊断急性一氧化碳中毒迟发性脑病的最佳影像学检查方法。

MRI Findings of Delayed Encephalopathy Caused by Acute Carbon Monoxide Poisoning

Objective To discuss MRI features of delayed encephalopathy due to acute carbon monoxide poisoning (DEACMP), to improve its diagnosis.Materials and Methods MRI findings in 19 cases with DEACMP were retrospectively analyzed.Results (1) Of 19 cases, 7 showed confluent foci within periventricular white matter and centrum semioval, presenting as massive symmetrically-distributed lesions with long T 1 and long T 2 signal. (2) Punctuate, spotty abnormal signal within globus pallidus was seen in 4 cases, of which the lesion was bilateral in 3 with long T 1 and long T 2 signal. The remaining one showed short T 1 and long T 2 signal in right globus pallidus, while long T 1 and long T 2 signal in left substantia nigra. (3)Symmetrical long T 1 and T 2 signal in periventricular white matter and centrum semioval, and abnormal signal in basal ganglia were seen in 8 cases, of which abnormal signal in bilateral globus pallidus was accompanied in 7, and abnormal signal in right internal capsule and in the head of left caudate nucleus was accompanied in one.Conclusion MRI is the best means for the diagnosis of delayed encephalopathy due to acute carbon monoxide poisoning.