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目的 总结海洛因海绵状白质脑病 (HSLE)的PET、MRI和病理特征。方法 2 8例患者的临床、CT和MRI分析 ,2例脑局部解剖和 8例脑活检组织用苏木素 伊红染色 ,神经元纤维染色 ,苏木素髓鞘染色、刚果红染色并进行电镜观察。结果 HSLP的临床、影像和病理特点 :(1) 2 8例有烫吸海洛因病史 ;(2 ) 2 8例有戒毒史 ,戒毒后症状加重 ;(3) 2 3例急性起病 ,首发症状多为小脑受损 ;(4 ) 4例PET顶枕及小脑皮质变薄 ,大脑白质扩大 ,1例未治疗患者内囊后肢、枕叶示小脑白质无代谢 ,3例已治疗患者代谢明显低减 ;(5 )CT和MRI示大脑 (2 5例 )、小脑白质广泛对称性受累 (2 8例 )。 结论HSLE患者CT和MRI示大脑、小脑白质广泛对称性受累 ,主要病理改变为脑白质海绵状空泡变性。PET在判断病情进展程度及治疗效果方面较MRI有明显优势。
Objective To summarize the PET, MRI and pathological features of heroin spongiform encephalopathy (HSLE). Methods 28 cases of patients with clinical, CT and MRI analysis, 2 cases of brain anatomy and 8 cases of brain biopsy tissue with hematoxylin and eosin staining, neuronal fiber staining, hematoxylin and myelin staining, and observed by electron microscopy. Results The clinical, imaging and pathological features of HSLP were as follows: (1) 28 cases had a history of heroin abuse; (2) 28 cases had history of drug addiction and the symptoms were aggravated after detoxification; (3) 23 cases had acute onset and the first symptom (4) 4 cases of PET top occipital and cerebellar cortex thinning, white matter enlargement, one case of untreated patients with hysterectomy, occipital white matter showed no white matter metabolism, three cases of patients treated significantly reduced metabolism; (5) Cerebral CT and MRI (25 cases) showed extensive symmetry of cerebellar white matter (28 cases). Conclusion The CT and MRI of HSLE patients show extensive symmetry of cerebellum and cerebellar white matter. The main pathological changes are degeneration of white matter of sponge. PET in determining the extent of the disease progression and the treatment effect than MRI has obvious advantages.