P型多系统萎缩的MRI表现

目的分析P型多系统萎缩(multiple system atrophy,MSA)的MRI特征,为临床诊断提供影像学依据。资料与方法回顾性分析经临床诊断为MSA-P型9例患者的常规MRI资料。结果 9例中,6例壳核有异常发现,其中壳核萎缩4例,壳核边缘长T2信号(裂隙征)2例,壳核弥漫性稍长T1、稍长T2信号3例,壳核后外侧极长T1、极短T2信号4例。6例中,单纯表现为壳核萎缩及壳核后外侧极长T1、极短T2信号各1例,余4例为多种壳核异常改变重叠出现。5例脑干有异常发现,其中"十字征"1例,全脑干萎缩4例;大脑半球异常5例,其中双额颞顶枕叶均萎缩3例,双额叶萎缩2例。小脑异常改变4例,其中2例小脑半球萎缩,2例小脑中脚对称性稍长T1、稍长T2信号。MSA-P型后期出现"十字征";液体衰减反转恢复(FLAIR)序列有利于发现异常信号。结论 MRI对于MSA-P型的临床诊断有重要意义。

MRI Features of Multiple System Atrophy P Type

Objective To analyze the MRI features of the multiple system atrophy(MSA) P,in order to provide imageology basis for clinical diagnosis.Materials and Methods MRI findings in 9 patients with MSA P type(parkinsonism in dominant multiple system atrophy)in XiangYa Hospital were analyzed retrospectively.Results Of 9 patients,6 had abnormal findings in putamen,4 had putamen atrophy,2 had the long T2 signal of the putamen edge(fissure sign),and 3 had the putamen diffuse little long T1 & T2 signals,and 4 had the very long T1 & very short T2 signals in outer back of putamen.Moreover,among these 6 patients,there was one case merely featured in the putamen atrophy and one in the very long T1 & very short T2 signal in the outer back of putamen,and the other 4 cases were found the abnormal changes in a variety of core shell overlap there.There were 5 cases of brain stem abnormalities,one with cross sign,and four with the whole brain stem atrophy(two were found the little long T1 & T2 signal concerning symmetry of the cerebellum feet).Hemisphere abnormalities were found in 5 cases,3 cases of them were the atrophy of both bilateral frontal temporal parietal occipitals,2 cases atrophy of bilateral frontal lobes.Cerebellar hemisphere atrophy was found in two cases.Cross sign was found in late MSA P type,and FLAIR sequences facilitate the detection of abnormal signal.Conclusion MRI facilitates the clinical diagnosis of MSA P type.