目的　探讨海洛因烟雾吸入所致的海绵状脑病的CT、MRI征象 ,提高对该病的认识和诊断水平。方法　对 4例加热吸食海洛因烟雾的患者进行颅脑CT或MR平扫和增强 ,MRI常规行SE序列平扫、增强 ,以及液体衰减反转恢复序列 (FLAIR)、磁共振波谱 (MRS)检查。结果　 2例CT扫描的病例表现为双侧小脑半球、脑干、内囊后肢、大脑脚、胼胝体压部、大脑后部脑白质对称性低密度灶 ,无强化。 2例MRI检查的病例也表现为相应区域长T1、长T2 信号 ,无强化。FLAIR像呈高信号 ,小脑病变较大脑明显 ,顶枕叶病变较额叶显著 ,MRS显示脑白质变性 ,乳酸升高。结论　该病的CT及MRI表现较具特征性 ,结合病史 ,可作出诊断。 Objective To investigate the CT and MRI signs of spongiform encephalopathy caused by inhalation of heroin smoke and to improve the level of understanding and diagnosis of the disease. Methods Four patients with heroin smoke heating were scanned and enhanced by CT or MR. The patients were routinely scanned and enhanced by SE sequence, FLAIR and MRS. Results Two cases of CT scan showed bilateral symmetrical low density lesion of bilateral cerebellar hemispheres, brainstem, internal capsule hind limbs, cerebral peduncle, corpus callosum and posterior cerebral white matter with no enhancement. Two cases of MRI examination also showed the corresponding region of long T1, long T2 signal, no enhancement. FLAIR showed a high signal, cerebellar lesions than the obvious brain, top occipital lobe lesions than the frontal significant, MRS showed white matter degeneration, increased lactate. Conclusion The CT and MRI manifestations of the disease more characteristic, combined with medical history, can make a diagnosis.