非酮症高血糖偏身舞蹈症的颅脑CT及MRI表现

目的分析非酮症高血糖偏身舞蹈症患者脑实质的影像学表现。方法回顾性分析16例经临床确诊的非酮症高血糖偏身舞蹈症患者的脑部CT和MRI表现。16例患者均接受至少1次CT平扫,其中10例接受至少1次MR检查,10例治疗后接受复查。结果 16例CT均见基底节区片状或条形稍高或高密度影,T1WI表现为基底节区条形或片状稍高或高信号,边界较清晰;其中1例DWI示病变区为稍低信号,1例为等信号,前者ADC值升高,后者无明显改变,1例SWI幅度像及相位像均显示病变区局部为条、片状低信号,FLAIR未见异常信号,增强扫描未见强化。9例治疗后血糖降到正常范围,复查头部CT或MR,其中5例病变消失,1例病变明显缩小,3例未见改变。1例治疗后血糖轻度降低,头部CT显示病变密度增高。10例随诊病例中,2例于原病灶区出现腔隙性梗死表现。结论非酮症高血糖舞蹈病具有特征性影像学表现,通常提示2型糖尿病。

Brain CT and MR findings of non-ketotic hyperglycaemia hemichorea

Objective To analyze brain parenchyma imaging features of non-ketotic hyperglycaemia chorea. Methods CT and MRI of 16 patients with clinically-proved non-ketotic hyperglycemia chorea were analyzed retrospectively. All patients underwent plain CT, 10 underwent MR for at least one time. Ten patients were reexamined with CT or MRI. Results Lesions in 16 non-ketotic hyperglycemia chorea patients all showed striatal or platy hyperdensity in basal ganglia on brain CT, and on T1WI with well-defined margin. One case revealed hypointencity, and the other revealed isointencity on diffusion-weighted imaging (DWI). The former's value of apparent diffusion coefficient (ADC) rose, and the latter's had no change. Striatal or platy hypointencity was detected on susceptibility-weighted imaging (SWI). The signal had no change on pre-enhancement and post-enhancement imaging. The lesion was not demonstrated on FLAIR imaging. After treatment, 9 patients had normal blood glucose. Reexamined CT/MR showed the lesions disappeared in 5 patients and shrank in 1 patient, did not change in 3 patients. Blood glucose aggravated in 1 patient, and brain CT showed higher intensity of lesion. Lacunar infarction occurred in 2 of 10 patients who received follow-up. Conclusion Non-ketotic hyperglycemia chorea has characteristic CT and MRI features, which often refer to type 2 diabetes.