海洛因烟雾吸入致海绵状白质脑病的CT、MRI表现

目的 探讨海洛因烟雾吸入所致的海绵状脑病的CT、MRI征象,提高对该病的认识和诊断水平。方法 对4例加热吸食海洛因烟雾的患者进行颅脑CT或MR平扫和增强,MRI常规行SE序列平扫、增强,以及液体衰减反转恢复序列（FLAIR）、磁共振波谱（MRS）检查。结果 2例CT扫描的病例表现为双侧小脑半球、脑干、内囊后肢、大脑脚 、胼胝体压部、大脑后部脑白质对称性低密度灶,无强化。2例MRI检查的病例也表现为相应区域长T1、长T2信号,无强化。FLAIR像呈高信号,小脑病变较大脑明显,顶枕叶病变较额叶显著,MRS显示脑白质变性,乳酸升高。结论 该病的CT及MRI表现较具特征性,结合病史,可作出诊断。

Spongiform leucoencephalopathy after inhaling heroin vapor: CT and MRI findings

Objective To explore CT and MRI features of spongiform leucoencephalopathy after inhaling "heroin" pyrolysate, and to improve the diagnostic ability of the disease. Methods Four patients, which inhaled heroin vapor, received the CT or MRI pre- and post-contrast scanning. MR sequences included conventional SE T 1WI, T 2WI, fluid attercuation inverse recover (FLAIR), and MRS. Results All 4 cases had similar symmetrical lesions involving the cerebellum, lateral brainstem, cerebral peduncles, posterior limbs of internal capsule, splenium of corpus callosum, medial lemniscuses, and posterior cerebral white mattes without enhancement. The lesions showed hypodense on CT and hypointense on T 1WI, hyperintense on T 2WI and FLAIR. Cerebellar lesions were more serious than cerebral one, and the parietooccipital lesions were serious than frontal one. MRS showed that the abnormalities in the white matter were degenerative changes, not necrosis. Conclusion CT and MRI findings of this diseases are characteristic. Combined with the history, the disease can be diagnosed.