皮层下动脉硬化性脑病CT诊断及临床分析

目的探讨皮层下动脉硬化性脑病(SAE)的病理变化、临床特点及CT主要征象,旨在提高SAE的诊断水平。方法收集我院94例SAE,男58例,女36例,年龄62～92岁,平均77岁。临床表现与症状多数病人有高血压、糖尿病、眼底动脉硬化及老年性痴呆。特点为进行性智力减退,不同程度偏瘫,语言不清或失语、头晕、眼花、恶心、手足麻木等。结果本病常见于60岁以上,CT特点为双侧脑室周围脑白质及半卵圆中心脑白质对称性低密度影,病变模糊不清,可伴发脑萎缩或腔隙性脑梗塞,有的可伴发脑出血和蛛网膜下腔出血。结论熟悉掌握本病的病理、临床及CT特点,对提高本病的诊断和鉴别诊断有重要价值。

CT diagnosis and clinical findings of subcortical arteriosclerotic encephalopathy

Objective A study of the pathology, clinical characteristics and major CT manifestations, in order to obtain a better understanding of the SAE. Methods In total 94 cases of SAE were enrolled in the study in Jun-an hospital ,included 58 males and 36 females, aged from 62-92 years (averagely 77 years). The clinical presentations of SAE included hypertension, diabetics, arteriosclerotisc eyeground, and stupor, characterized by progressive decline of intellectual function, different-level of paralysis, aphasia, swirl, dazzle, naupathia,extremity numbness. Results A predominance was found in the patients aged more than 60 years. CT scan showed symmetrical hypodense shadows with poorly-defined border, complicated with the sign of lacunar infarction, cerebral atrophy, parenchymal hemorrhage and/or subarachnoid hemorrhage in some cases. Conclusion A good understanding of the clinical and CT features of subcortical arteriosclerotic encephalopathy is valuable for CT diagnosis and differentiated diagnosis.