肝移植术后桥脑中央髓鞘溶解症常规MRI及DWI表现

目的：探讨肝移植术后桥脑中央髓鞘溶解症的临床和MRI表现，提高诊断水平。方法：3例原位肝移植术后患者分别于术后3～21d出现神志不清、嗜睡、双下肢肌力减低等表现，均于2d内行MRI扫描，总结MRI表现及诊断要点。结果：MRI表现为桥脑中央对称性稍长T1、较长T2信号，DWI均为高信号，ADC为低信号。2例病灶累及大脑皮层，1例并发基底节脑脓肿？2例患者35d和2个月后复查MRI，病变范围明显变小，边界变清，DWI为等信号、结论：肝移植患者电解质紊乱可导致桥脑中央髓鞘溶解症，MRI具有典型的表现，根据MRI可做出正确诊断。

MR and DWI Imaging of Central Pontine Myelinolysis after Liver Transplantation

Objective To study the clinical and MRI features of central pontine myelinolysis after liver transplantation. Methods 3 cases of orthotopic liver transplantation patients, displaying unconsciousness, drowsiness, reduced muscle strength of both lower extremities 3 to 21 days after the operation respectively, went through MRI scan in 2 days.Results MRI showed that symmetric long T1 and T2 signals, high-signal-intensity DWI and low-signal-intensity ADC were found in central pontine region. The cerebral cortex was involved in 2 cases, and abscess in basal ganglia appeared in 1 case. MRI examination showed that 2 cases had decreased lesion range, clear boundary and equal-signal-intensity DWI 35 days and 2 months respectively after. Conclusion MRI is valuable for the diagnosis of the patient with central pontine myelinolysis after liver transplantation.