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目的探讨海洛因脑病(heroin-associated encephalopathy, HE)的MRI特点及其病理基础。方法34例病例中, 根据流行病学、临床表现、MRI、实验室检查及其中10例病理检查结果, 排除其他疾病而诊断HE。MRI检查用1.5TMRI扫描仪, 行T1WI、T2WI、FLAIR 检查。4例死亡患者中2例进行尸解,8例行脑立体定向活检。MRI与病理对照分析。结果34例HE, 全部病例T1WI低信号,T2WI高信号。病灶同时累及幕上半球、脑干及小脑占 85.3%, 三者分别单独受累均<10%。病灶以累及脑白质为主。脑内两侧同时受累占91.2%。MRI显示的幕上半球“八字征”、脑干的“中空征”、及小脑的“蝶翼征”诊断HE有一定意义。MRI信号改变, 主要与HE的脑白质脱髓鞘及大量空泡形成, 这些空泡构成海绵状结构, 内含液体增多有关。结论MRI对HE能准确的定位定量诊断,并有一定特征MRI表现。MRI显示HE与病理之间有很好的相关性。
Objective To investigate the MRI features and pathological basis of heroin-associated encephalopathy (HE). Methods According to the epidemiology, clinical manifestations, MRI, laboratory tests and 10 cases of pathological findings, 34 cases were diagnosed as HE without other diseases. MRI examination with 1.5TMRI scanner, line T1WI, T2WI, FLAIR examination. Two of the four patients died of autopsy and eight had stereotactic biopsy. MRI and pathology control analysis. Results 34 cases of HE, all cases of T1WI low signal, T2WI high signal. Lesions involving the supratentorial hemisphere, brainstem and cerebellum accounted for 85.3%, respectively, three were involved <10%. Lesions mainly involving the white matter. Both sides of the brain involved 91.2% at the same time. MRI shows the supracharacters “eight character”, “hollow syndrome” of the brain stem, and cerebellar “butterfly wing syndrome” diagnosis of HE has some significance. MRI signal changes, mainly with the demyelination of HE white matter and the formation of a large number of vacuoles, these vacuoles constitute a sponge-like structure, containing increased fluid related. Conclusion MRI can accurately locate and quantify HE with certain features of MRI. MRI showed a good correlation between HE and pathology.