脑卒中后锥体束华勒变性的影像诊断

目的通过分析脑卒中后锥体束华勒变性的影像表现,以提高对该病的认识和诊断水平。方法收集脑卒中累及单侧大脑半球锥体束的病变并继发华勒变性病例76例,均行常规磁共振成像(MRI)(T1WI、T2WI、FLAIR)及CT平扫,并对影像资料进行统计分析并总结。结果在原发病变基础上,可见继发病变均沿锥体束方向分布;CT表现为等或低密度,MRI表现为等或稍长T1、稍长T2信号,FLAIR呈稍高信号;变性晚期MRI及CT均显示伴有患侧大脑脚及桥脑萎缩。结论脑卒中累及锥体束可导致锥体束继发性华勒变性,通过辨识原发病灶与继发病灶的关系,再结合病变的分布特点及相应影像表现,诊断不难。

The radiology diagnosis of Wallerian degeneration in pyramidal tract in post-apoplexy patients

Objective To analyze the findings of imaging in the diagnosis of Wallerian degeneration（WD） in Pyramidal tract in post-apoplexy patients, to improve the diagnostic accuracy of WD. Methods Seventy six cases with one side of hemisphere WD in pyramidal tract were analyzed by magnetic resonance imaging （MRI）, with T1WI, T2WI, FLAIR and by CT. Results Lesions were found along the pyramidal tract besides the protopathy. CT scan showed the isodense or low dense, whereas in MRI, showed the long T1/T2 signal, mild high signal in FLAIR, MRI and CT were shown with late degeneration of lateral cerebral peduncle brain atrophy and bridge. Conclusion Cerebral apoplexy involving the pyramidal tract can lead to pyramidal tract secondary WD, by identifying its relationship with secondary lesions from the primary lesion, coupled with the distribution characteristics of pathological changes and the corresponding image performance, diagnosis is not difficult.