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目的探讨脑出血后锥体束继发性损害的磁共振成像(MRI)特点及意义。方法回顾性分析住院治疗首次单发病灶,伴有锥体束不同程度损害,曾于急性期(7天)内及亚急性期(21天)后分别进行头颅MRI检查的脑出血患者,同时分析在第二次MRI资料的T2/FLAIR图像上,在同侧远离血肿下方的大脑脚、脑桥及延髓出现异常信号患者的MRI资料。结果本组11例患者,男10例,女1例。MRI显示,第一次MRI检查中,所有患者在同侧远离血肿部位下方的大脑脚、脑桥、延髓等平面无异常信号;在第二次检查的T2/FLAIR图像上,所有患者在同侧远离血肿部位下方的大脑脚、脑桥、延髓等一个或多个平面上出现边缘不清的异常信号,其中2例为低信号,余9例为高信号。结论 MRI可以检测到局灶性脑出血后锥体束继发损害的现象,这种现象不应被误解为新发脑梗死或其他病变。
Objective To investigate the magnetic resonance imaging (MRI) features and significance of pyramidal tract secondary damage after intracerebral hemorrhage. Methods We retrospectively analyzed the first single-foci of hospitalized patients with varying degrees of pyramidal tract lesions, patients with cerebral hemorrhage who underwent craniocerebral MRI examination in acute phase (7 days) and subacute phase (21 days) In the second MRI data T2 / FLAIR images, in the ipsilateral hematoma away from the brain under the foot, pons and medulla oblongata abnormal signal in patients with MRI data. Results The group of 11 patients, 10 males and 1 female. MRI showed that all patients had no abnormal signal on the ipsilateral side away from the brain, pons and medulla oblongata below the site of hematoma. On the T2 / FLAIR images of the second examination, all patients were on the same side away from each other Below the site of hematoma, abnormal marginal signals appeared on one or more planes, such as cerebral pons, pons, medulla oblongata. Among them, 2 were low signal and 9 were high signal. Conclusion MRI can detect the secondary damage of pyramidal tract after focal cerebral hemorrhage. This phenomenon should not be misinterpreted as a new cerebral infarction or other pathological changes.