Leigh综合征头颅质子磁共振波谱影像表现探讨
发表时间：2014-06-30 浏览次数：1124次
田树平，杨立，叶宏军等.综合征头颅质子磁共振波谱影像表现探讨[J].临床误诊误治, 2013, 26(3). 63-65
Leigh综合征 磁共振波谱学 磁共振成像
田树平，杨立，叶宏军，王占宇，花焱 ，王子军，张燕群，郭勇
(海军总医院放射科,北京,100048)
2013
63-65
知网,万方
目的 探讨Leigh综合征头颅质子磁共振波谱(1H-MRS)的影像特点及诊断价值.方法 对我院收治的临床诊断为Leigh综合征10例的头颅MRI及1H-MRS表现进行回顾性分析.结果 本组10例双侧基底节区及中脑导水管周围灰质区、3例脑干背侧、1例小脑常规MRI检查均可见对称性长T1、长T2信号,FLAIR像上为高信号.弥散加权成像(DWI)7例显示高信号,扩散系数(ADC)图呈低信号；3例表现为等及低信号.10例灌注加权成像(PWI)示双侧豆状核、尾状核病灶均为高灌注,但其他部位病灶表现为低灌注.本组病变区域1H-MRS表现为胆碱峰升高,N-乙酰天门冬氨酸峰降低；病变区域、脑脊液及常规MRI图像表现正常的区域均可见巨大乳酸双峰.结论 对Leigh综合征1H-MRS可提供直接反映疾病代谢异常的信息,联合应用常规MRI、DWI、PWI有利于该病的诊断和鉴别诊断. [Abstract一Objective To explore the characteristics and value of spectrum on brain proton magnetic resonance spectrosco- p`.('H-MRS) and its value in diagnosis of Leigh syndrome. Methods -H-MPiS and'VIRI of 10 patients with Leigh syndrome in om hospital were retrospectively analyzed. Results Hyperintensity on T2WI/FLAIR and hypointensity on T1Wl were presented in 10 patients'bilateral basal ganglia and periaqueductal gray matter(PAC ) , in 3 patients'dorsal brain stem and in 1 patient's cerebellar nuclei. 7 patients showed hyperintense on diffuse weighing imaging(D}%I) and hvpointensity on diffusion coefficient (ADC);3 pa- bents showed equal hypointensity. Perfusion weighted imaging(P\X I) of 10 patients showed hypertransfusion on bilateral lenticular nucleus and caudate nucleus lesions，and hypope}fusion on the other positions of lesions. ' H-MRS of the Leigh syndrome cases showed elevated choline(Gho) peak and decreased N acetvlaspartate(NAA) peak; huge two-humped lactates were presented in the diseased region, cerebrospinal fluid(CSF) and normal areas by routine brain MRl imaging. Conclusion’H-MRS may directly re- Elect the metabolism changes of Leigh syndrome, and may be helpful in diagnosis and differential diagnosis of the disease when tom- bined with routineMRI，DWI and PW1.
