纹状体梗死后黑质继发性损害的磁共振表现与意义

目的探讨常规磁共振(conventional magnetic resonance imaging,MRI)检测纹状体梗死后黑质继发性损害的敏感性及其影像学特点。方法对首次发病、确诊为单侧基底节区新发纹状体梗死患者,分别在急性期(7 d)、亚急性期(8～21 d)及慢性期(3个月以后)进行1次或多次常规MRI检测,分析其MRI资料。结果本研究中纹状体梗死患者70例,MRI检测提示黑质继发性损害患者27例(38.57%),2例患者出现双上肢齿轮样肌张力升高、面部表情缺失、等类似帕金森病样症状。纹状体梗死后黑质继发性损害的MRI表现为,梗死灶同侧黑质在急性期、亚急性期在T2及FLAIR出现斑片状高信号改变,而且该信号改变在慢性期逐渐消失。结论纹状体梗死后黑质的继发性损害在MRI上有特征性改变,而且可能参与血管性帕金森综合征的发病过程。

The MRI study of the secondary degeneration of the substantial nigra after striatum infarction

Objective To explore the secondary degeneration of the substantia nigra(SN) after striatal infarction with conventional magnetic resonance imaging(MRI).Methods Seventy patients with striatal infarct underwent 3 MRI scans at acute(within 7 d),subacute(8 to 21 d) and chronic stages(after 3 months).Results MRI revealed the secondary degeneration in the ispilateral SN in twenty seven(38.57%) of 70 patients.The secondary SN degeneration appeared as a hyperintense signal confined to the ipsilateral SN on T1-imaging during acute and subacute stages.Two patients developed some Parkinson-like symptoms including cogwheel rigidity in upper limbs and lack of facial expression.Conclusions The secondary degeneration of the SN following striatal infarction has typical MRI appearance and may cause vascular Parkinson syndrome.