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目的 探讨海洛因海绵状白质脑病 (HSL E)的 CT、MRI和 PET特点。方法 对 2 9例患者的CT、MRI以及 4例患者的 PET资料进行分析。结果 (1) CT和 MRI显示病变位于双侧小脑、内囊后肢、枕顶叶深部等部位白质 ,病灶广泛且对称 ;(2 ) CT示界限清楚的低密度病灶 ,MRI呈长 T1 WI、长 T2 WI异常信号 ,无水肿 ,快速反转恢复序列 (FL AIR)和增强扫描提示血脑屏障无破坏 ,PET显示为低代谢或无代谢病灶 ;(3)未治疗患者内囊后肢、枕叶和小脑白质无代谢 ,康复期患者代谢明显减低 ;(4 )临床症状改善者和未治疗者小脑皮质代谢降低 ,临床症状明显改善者代谢正常。结论 HSL E患者的 CT和 MRI改变多局限于白质 ,极为相似。 PET显示病变部位低代谢或无代谢 ,小脑皮质和白质代谢的恢复对 HSL E患者的临床转归非常重要 ,故判断 HSL E患者的转归 ,PET较之 MRI更有价值
Objective To investigate the CT, MRI and PET features of heroin cavernous leukoencephalopathy (HSL E). Methods The CT and MRI data of 29 patients and the PET data of 4 patients were analyzed. Results (1) CT and MRI showed that the lesions were located in bilateral cerebellum, the hind limb of the internal capsule and the deep part of the occipital parietal lobe. The lesions were extensive and symmetrical. (2) CT showed a clear demarcated low-density lesion with long T1 WI and long T2 WI abnormal signal, no edema, FL AIR and enhanced scan suggest no damage of the blood-brain barrier, PET showed low metabolism or no metabolic lesions; (3) The untreated patients with hind limb, occipital and Cerebellar white matter without metabolism, convalescent patients significantly reduced metabolism; (4) improved clinical symptoms and no treatment of cerebellar cortex metabolism is reduced, significantly improved clinical symptoms were normal metabolism. Conclusions CT and MRI changes in HSL E patients are mostly confined to white matter and are very similar. PET showed low or no metabolism of the lesion, the recovery of cerebellar cortex and white matter metabolism is very important for the clinical outcome of patients with HSL E, so judging the outcome of HSL E patients, PET is more valuable than MRI