桥脑中央髓鞘溶解症MRI表现及其在诊断中的应用

目的:探讨5例桥脑中央髓鞘溶解症(CPM)患者的MRI表现,阐明MRI在诊断CPM方面的应用,以提高其诊断水平。方法:收集5例CPM患者的主要病史和临床表现。应用Philip Achieva 3.0T超导MR,采集从后颅窝底到颅顶的T1WI、T2WI、Fiair和弥散加权像(DWI)序列。结果:CPM的MRI表现为桥脑中央受累,皮质脊髓束的轴索无损害,无占位及水肿; T1WI呈低信号,T2WI及T2 Flair呈高、稍高信号,DWI呈高信号或等信号,增强后周边轻度强化或无强化;病灶呈"凸"字形,栗形或斑片状;少数累及基底节、皮层、小脑等脑桥外结构。结论:CPM的MRI表现较具特征性,MRI检查可为CPM的早期诊断提供帮助。

MRI performance of central pontine myelinolysis and its application in diagnosis

Objective To investigate the MRI performance of five cases of central pontine myelinolysis (CPM),and to clarify the application of MRI in the diagnosis of CPM in order to improve its diagnosis level. Methods The main history and clinical manifestations of 5 patients with CPM were collected.The Philip Achieva 3.0T superconducting MR was used to detect the sequences of T1WI,T2WI,Fiair and diffusion-weighted imaging(DWI) from the bottom of posterior fossa to parietal. Results The MRI performance of CPM as follows:the location of CPM was in the center of the pons,and the transverse pontine fibers were most severely affected with the sparing of descending corticospinal tracts,and there was no mass or edema;the lesion appeared hypointense on T1 weighted image and hyperintense or slightly hyperintense on T2 weighted image and T2 Flair image,hyperintense or isointense on DWI image,and surrounding mild enhancement or no enhancement after enhancement scan.The lesion showed "convex" glyph,chestnut or patchy;few pons exostructure was involved such as basal ganglia,cortex,and cerebellum structure. Conclusion The MRI performance of CPM has its characteristics,and MRI images could be used in early diagnosis of CPM.