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目的:探讨多种影像技术对MELAS型线粒体脑肌病的诊断价值。方法:回顾性分析14例MELAS患者的临床资料及多种影像技术检查结果。结果:本组病例均行MR扫描,13例显示脑内多发性或游走性恼梗死样病灶,主要累及大脑半球后部皮层和皮层下,病变与血管分布区尤关,1例主要表现为白质内改变,均呈为长T_1、长T_2信号,6例显示不同程度的脑萎缩;6例行MRA扫描,其中2例MRA示病灶处血管分支明显增粗:13例行MRS扫描,其中10例MRS在病灶处检出乳酸双峰,1例在脑脊液中检出乳酸双峰:1例行DSA检查示病灶内血管分支增粗,血运加快。8例行CT检查病灶均呈低密度改变。结论:综合应用多种影像技术,可明显提高MELAS的诊断准确性,对其早期诊断、指导治疗、判断疗效和提示预后具有重要价值。
Objective: To explore the diagnostic value of multiple imaging techniques for MELAS-type mitochondrial encephalomyopathy. Methods: Retrospective analysis of 14 cases of MELAS patients with clinical data and a variety of imaging test results. Results: The MR scan was performed in all the patients. Thirteen cases showed multiple paroxysmal or migratory arrhythmia-like lesions in the brain, which mainly involved the posterior cortex and cortex of the hemisphere. The lesions and vascular regions were closely related to each other. One case was mainly 6 cases showed different degrees of brain atrophy. MRA scan was performed in 6 cases, of which 2 cases showed obvious thickening of blood vessel branches in MRA scans: 13 cases underwent MRS scan, of which 10 Cases of MRS in the lesion detected double peaks of lactic acid, lactalbumin in the cerebrospinal fluid was detected in 1 case: 1 case of DSA examination showed thickening of the lesion within the blood vessels, blood flow faster. 8 routine CT examination of lesions showed low density changes. Conclusion: The comprehensive application of a variety of imaging techniques can significantly improve the diagnostic accuracy of MELAS, which is of great value to early diagnosis, guidance and treatment, judgment of curative effect and prognosis.