基底节梗死的CT、MR和MRS诊断

目的　通过总结17例基底节梗死的CT和MR表现,探讨基底节梗死的影像学诊断和鉴别诊断。方法　17例基底节梗死, 6例为儿童,发生在外伤后,年龄5~11岁,平均8岁。11例发生在成人,年龄53~78岁,平均63岁。17例行CT平扫, 11例行MR扫描, 5例行氢质子波谱检查。结果　6例儿童外伤后基底节梗死均为单侧病变, 11例成人基底节梗死中, 10例为单侧病变, 1例为双侧病变。CT扫描基底节梗死表现为低密度,MRT1 加权图呈低信号,T2 加权图呈高信号。同侧侧脑室前角受压变窄。氢质子波谱均出现明显的Lac波, 4例NAA波明显降低, 1例NAA波轻度降低。2例基底节梗死合并出血。结论　基底节梗死主要见于动脉硬化的老年人和儿童外伤后,CT和MR表现很有特点,但需要与其他原因引起的基底节病变鉴别,氢质子波谱出现明显的Lac波是其特征。

CT, MR and MRS Diagnosis of Basal Ganglia Infarction

Objective To discuss imaging differentiating diagnosis of basal ganglia infarction by summarizing the features of 17 lesions on CT and MRI.Methods Among 17 cases, 6 were children occurred after their injury, and ranged in age from 5 to 11 years old with average 8 years old. Others were adults ranged in age from 53 to 78 years old with average 63 years old. All patients were examined with CT plain scans. 11 cases were underwent MRI and 5 were underwent 1 H MRS.Results 6 lesions in children were all single lateral cases. Among 11 adult lesions, 10 were single lateral and 1 was bilateral case. Basal ganglia infarctions demonstrated hyposignal on T_1WI, hypersignal on T_2WI and hypodense on CT. The lateral ventricles' anterior horns of the same side were pressed and narrow. On 1 H MRS, Lac was obviously observed in all lesions. NAA decreased markedly in 4 lesions and slightly in 1 lesion. 2 basal ganglia infarctions were together with hemorrhage.Conclusion Basal ganglia infarctions were mainly observed in the elder with arteriosclerosis and injured children. Its features on CT and MRI are characteristic, but it is in need of differentiating from basal ganglia lesions caused by other reasons. Marked Lac on 1 H MRS is its character.