急性一氧化碳中毒及迟发性脑病的临床与MRI

目的探讨急性一氧化碳中毒(ACOP)及迟发性脑病(DEACMP)患者的临床表现与头颅MRI特点。方法对ACOP 564例、DEACMP 102例患者均行头颅MRI及DWI检查,急性期患者在入院后48h内进行检查,DEACMP在临床出现异常表现后即行头颅MRI检查。结果 ACOP患者临床表现及MRI表现可分为3型:①苍白球受累型;②弥漫性脑肿胀型;③大脑皮质及白质受累型。DEACMP患者临床表现及MRI表现可分为5型:(1)脑白质受累型;(2)基底节受累型;(3)枕叶皮层受累型;(4)小脑半球受累型;(5)多灶型。结论 ACOP及DEACMP的MRI表现既有相同点又有区分点,临床应加以区分,并依据MRI的表现作出不同诊断与治疗。并报道了CO中毒并发皮质盲12例及持续低热3例。

Clinical and MRI manifestations of acute carbon monoxide poisoning and delayed encephalopathy after acute carbon monoxide poisoning

Objective To investigate the clinical and MRI manifestations of acute carbon monoxide poisoning(ACOP) and delayed encephalopathy after carbon monoxide poisoning(DEACMP).Methods 564 patients with ACOP and 102 patients with DEACMP were enrolled in this study.Patients with ACOP underwent MRI and DWI within 48 hours after hospital admission while others with DEACMP were checked by that when they appeared abnormal clinical symptoms.Results ACOP were classified into three types according to clinical and MRI findings:globus pallidus involvement,diffuse brain swelling,cerebral cortex and white matter involvement.DEACMP were classified into five types according to clinical manifestations and MRI findings:white matter involvement,basal ganglia involvement,occipital cortex involvement,cerebellar hemisphere involvement,multifocal malignant involvement.Conclusion There are both similarities and differences between ACOP and DEACMP.For this,we shall try to distinguish them in order to provide evidence for clinical diagnosis and treatment.It is the first report that CO poisoning can lead to cortical blindness of 12 cases and persistent low fever of 3 cases.