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目的探讨不同临床类型Marchiafava-Bignami病(MBD)的MRI表现特点。方法回顾性分析35例MBD患者的临床和MRI资料,依据起病形式分为急性型、亚急性型和慢性型,分析各型MBD患者胼胝体病变、胼胝体以外病变的分布、形态和信号特点。结果急性型14例,亚急性型12例,慢性型9例。急性型8例胼胝体肿胀,3例形态正常,3例轻度萎缩;亚急性型9例胼胝体形态正常,2例肿胀,1例萎缩;慢性型6例胼胝体形态萎缩,3例正常。胼胝体病变左右对称者35例;胼胝体病变呈整体分布33例,局部分布2例;胼胝体上下缘清楚34例,胼胝体上下缘不清楚1例。出现“夹心饼干”征象24例,胼胝体中层坏死囊变19例。35例中34例发现胼胝体以外病灶,双侧病变基本对称,双侧半卵圆中心及额顶叶白质出现病变者34例,前连合、小脑中脚出现病变者分别为13、12例,颞枕叶白质内、皮质内出现病变者各3例。35例患者胼胝体病变于DWI呈高信号或稍高信号。结论MBD的病变可发生于胼胝体和胼胝体外多个部位,多数累及整个胼胝体。急性型MBD以胼胝体肿胀为主,慢性型以胼胝体萎缩为主。胼胝体病变的对称分布、“夹心饼干征”和DWI高信号或稍高信号是MBD的特征性MRI表现。
Objective To investigate the MRI features of different clinical types of Marchiafava-Bignami disease (MBD). Methods The clinical and MRI data of 35 patients with MBD were retrospectively analyzed. According to the onset forms, they were divided into acute type, subacute type and chronic type. The distribution, morphology and signal characteristics of the corpus callosum lesions and other corpus callosum were analyzed. Results Acute type in 14 cases, subacute type in 12 cases, chronic type in 9 cases. In the acute type, the corpus callosum was swollen in 8 cases, normal in 3 cases and slight atrophy in 3 cases. The subacute type of corpus callosum was normal in morphology, swollen in 2 cases and contracted in 1 case. The chronic corpus callosum was atrophic in 6 cases and normal in 3 cases. The corpus callosum lesions symmetry in 35 cases; corpus callosum lesions were overall distribution in 33 cases, local distribution in 2 cases; the upper and lower edge of the corpus callosum clear 34 cases, the upper and lower margin of the corpus callosum is not clear in 1 case. Appeared “sandwich biscuit ” signs in 24 cases, cystic corpus callosum necrosis in 19 cases. 34 cases of 35 cases found lesions outside the corpus callosum, bilateral lesions were basically symmetrical, bilateral semiloots and the frontal lobe white matter lesions occurred in 34 cases, anterior commissure, cerebellar lesions were found in 13,12 cases, Temporal occipital white matter, cortical lesions occurred in 3 cases. In 35 patients, corpus callosum lesions showed high or slightly high signal intensity on DWI. Conclusion The lesions of MBD may occur in many parts of the corpus callosum and corpus callosum, most involving the entire corpus callosum. Acute type MBD mainly corpus callosum, chronic corpus callosum atrophy based. The symmetrical distribution of the corpus callosum lesions, the “sandwich cookie sign” and DWI high or slightly high signal are characteristic MRI findings of MBD.