胼胝体压部单发病灶的 MRI 诊断

目的：探讨 MRI 对胼胝体压部单发病灶的诊断价值。方法对9例胼胝体压部单发病灶患者的影像、临床资料及部分患者的随访结果进行回顾性分析、总结。结果(1)临床表现：4例出现头痛、头晕,3例出现一过性晕厥,2例出现发热,2例出现肢体活动障碍。(2)临床诊断：低血糖脑病 3例,1月后复查 MRI 患者病变已吸收消失；脑炎 2例,治疗后好转；脑梗死、癫痫、变性及脑外伤各1例,治疗后病灶仍存在。(3)影像表现：均表现为胼胝体压部单发的类圆形、片状稍长 T1稍长 T2信号影,边界清楚,在扩散加权成像(DWI)上呈高信号,在表观扩散系数(ADC)图为低信号,无明显强化表现。结论多种疾病均可引起胼胝体压部单发病灶,其影像表现相似,其中低血糖脑病及脑炎的影像表现有一定特点(具有可逆性),要明确诊断需结合临床资料及病史。

MRI diagnosis of single lesion in the corpus callosum department

Objective To evaluate MRI diagnostic value for single lesion characteristics in the splenium of corpus callosum.Methods MRI features,clinical data,and parts of follow-up results of 9 cases with single lesion in the splenium of corpus callosum were analyzed retrospectively.Results (1)Clinical manifestations:headache and dizziness occurred in 4 cases,syncope in 3 cases,fever in 2 cases, physical activity barriers in 2 cases.(2)Clinical diagnosis:hypoglycemic encephalopathy were rescaned one month later in 3 cases, in which the previous lesion completely disappeared.Clinical experience of encephalitis were improved after treatment in 2 cases. Cerebral infarction,epilepsy,brain injury and degeneration were diagnosed respectively in each one case,in which lesion still existed after treatmented.(3)Image findings:despite the different clinical manifestations,image features of all cases were quite similar. Round or foliated like lesions of slightly long T1 and long T2 signals in the splenium of corpus callosum were presented in all cases. High signals on diffusion weighted imaging and low signals on the ADC were showed with same lesions,andno obvious enhancement after contract media injected was seen.Conclusion Single lesions in the splenium of corpus callosum are showed in many diseases. The image features of hypoglycemic encephalopathy or encephalitis have certain characteristics (single lesion is reversible).Accurate diagnosis need to combine with clinical data and medical history.