磁共振弥散加权对克-雅氏病早期诊断的意义

目的探讨克-雅氏病(Creutzfeldt-Jakob disease,CJD)早期的磁共振弥散加权成像(DWI)表现。方法回顾性分析和总结3例CJD患者的临床症状及体征、影像学、脑电图和脑脊液中14-3-3蛋白的改变等资料。结果 3例患者脑部MRI均表现为皮质不同程度的DWI"缎带样"高信号,脑电图均出现周期性尖慢波或三相波,脑脊液14-3-3蛋白2例(+),1例(-)。结论对于绝大部分CJD患者,无论脑电图和脑脊液中14-3-3蛋白是否改变,DWI即可先于前两者出现异常改变,对于临床上出现早期相应症状及体征的患者,若DWI有此特征性改变,应高度疑诊CJD,故应考虑将DWI的异常改变纳入CJD的临床诊断标准中。

Diffusion-weighted imaging on the significance of early diagnosis of Creutzfeldt-Jakob disease

Objective To investigate the role of diffusion-weighted imaging(DWI) in early diagnosis of Creutzfeldt-Jakob disease(CJD).Methods The clinical manifestation,neuroimaging,electroencephalogram(EEG) and 14-3-3 protein in cerebrospinal fluid(CSF) were retrospectively analyzed.Results DWI of three cases showed abnormal hyperintensities as ribbons in cerebral cortex in various degrees.EEG showed periodic sharp wave complexes(PSWC).Two patients’ 14-3-3 protein was positive in CSF.Conclusion DWI will have abnormal change.If there are the abnormal hyperintensities on DWI in patients with symptoms and signs of CJD,the diagnosed of CJD should be considered.So it can be considered to take the abnormal change in DWI into the clinical diagnostic criteria of CJD.