低血糖脑病的影像学特征

目的探讨低血糖脑病的影像学特征。方法回顾性分析7例低血糖脑病患者的核磁共振资料。结果低血糖脑损害有高度的区域选择性,可不对称。主要累及大脑皮层、海马、基底节和胼胝体压部,甚至皮层下白质;MRI表现为等或稍长T1、长T2信号,DWI呈高信号,伴ADC值降低,部分病变可逆;MRS示病变区乳酸峰无明显变化。结论低血糖脑损害有很强的区域选择性、可不对称;DWI对病变更敏感;大脑皮层和基底节区受累者预后不佳,侵犯胼胝体压部者预后好。

Neuroimaging features of hypoglycemic encephalopathy

Objective To investigate the neuroimaging features of hypoglycemic encephalopathy（HE）. Methods The magnetic resonance images of 7 patients with HE were analyzed retrospectively. Results MR images revealed specific lesions in HE, which was asymmetry and reversibe. There were isointense or hypointense abnormalities on T1 weighted images and hyperintense abnormalities on T2-weighted and diffusion- weighted images in the cerebral cortex, hippocampus, basal ganglia, the splenium of corpus callosum, and even the subcortical white matter, sparing the thalamus and cerebellum. DWI showed the areas of involvement at an earlier time better than conventional MRl,with the reduced apparent diffusion coefficient. MR spectroscopy revealed no evidence of abnormal lactate in the affected cerehral cortex. Conclusions MRI can show highly selective lesions in HE, which are asymmetry and reversibe. DWI can be more sensitive than conventional MRI in detecting the lesions. Lesions of the basal ganglia and cerebral cortex are often with a poor outcome, and involvment in the splenium of corpus callosum may be with good outcome.