胼胝体压部局灶性变性和水肿病变的MR表现

目的讨论胼胝体压部(SCC)局灶性变性和水肿病变的MRI特点.方法回顾性分析24例SCC变性和水肿病变的MRI及临床特点.结果5例海洛因吸入脑病(LHVI)、6例肾上腺脑白质营养不良(ALD)为弥漫均匀病灶.7例轴索损伤(DAI)及3例脑脂肪栓塞(FEB)为弥漫不均匀病灶.1例病毒性脑炎(VE)呈居中类圆形病灶.2例LHVI为累及后部边缘的薄带形病灶.4例DAI和1例FEB行MRI复查,发现SCC病灶消失.4例LHVI复查未见病变明显变化.结论SCC病变的影像表现及随诊复查有助于水肿与变性病变的鉴别,而且SCC病灶能反映LHVI的白质受累程度范围.

MR appearances of circumscribed leukoencephalopathies and edema lesions of the splenium of corpus callosum

Objective To describe the MRI findings of the circumscribed edema and leukoencephalopathy lesions of the splenium of corpus callosum (SCC). Methods The MRI findings of 24 patients with brain edema and leukoencephalopathy of the SCC were retrospectively reviewed. The MRI findings and clinical features were analyzed. Results Five cases of leukoencephalopathy after herion vapor inhalation (LHVI) and 6 cases of adrenoleukodystrophy (ALD) had diffusive homogeneous lesions of SCC. Seven cases of diffuse axonal injury (DAI) and 3 cases of fat embolism of brain (FEB) had diffusive inhomogenous lesions of SCC. One patient of virus encephalitis (VE) had single midline oval lesion of SCC, while 2 cases of LHVI had thin banding marginate lesions at the back part of SCC. The lesions of 4 cases with DAI and 1 case with FEB were disappeared in follow up MRI. Four cases with LHVI did not show any change in follow up MR examination. Conclusion The MRI features and the reversibility of the follow up MRI can be helpful in differential diagnosis of encephalopathies and edema lesions of the SCC. The lesion scope of the splenium of LHVI can reflect the prognosis of white matter disease.