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目的:分析急性双侧中线旁丘脑梗死综合征的影像学表现特点。方法:回顾性分析我院2014年10月~2017年1月经临床证实的8例急性双侧中线旁丘脑梗死综合征患者的临床和影像学资料。全部患者均于发病24 h内完成首次颅脑CT检查,5 d内完成首次颅脑MRI检查,3例有MRA检查资料。结果:首次CT检查病灶不明显3例,4例双侧中线旁丘脑可疑或小灶性低密度灶,1例双侧中线旁丘脑明确的较为对称性低密度灶。MRI均显示双侧中线旁丘脑较为对称性分布的蝶形T1WI低或略低、T2WI高或略高信号、FLAIR高或略高信号及DWI上为高信号、ADC低信号,其中以DWI高信号为特征。影像学随访中病灶进展4例。4例病程中可见中脑“V”字型梗死。3例MRA均可见单侧或双侧大脑后动脉及其分支狭窄。结论:影像学检查手段尤其是MRI,对急性双侧中线旁丘脑梗死综合征的早期诊断及鉴别诊断具有重要价值。
Objective: To analyze the imaging features of acute bilateral midline hypothalamic infarction syndrome. Methods: The clinical and radiographic data of 8 patients with acute bilateral midbrain paralyzemia infarction syndrome who were confirmed clinically in our hospital from October 2014 to January 2017 were retrospectively analyzed. All patients completed the first CT scan within 24 hours of onset, the first MRI scan of brain was completed within 5 days and the MRA data of 3 cases. Results: The first CT examination of the lesion was not obvious in 3 cases, 4 cases of bilateral midline hypothalamic suspicious or focal low density foci, and 1 case of bilateral midline hypothalamic clear symmetric low density foci. MRI showed symmetry of bilateral midline hypothalamus symmetrical distribution of butterfly T1WI low or slightly lower, T2WI high or slightly higher signal, FLAIR high or slightly higher signal and DWI is high signal, ADC low signal, which DWI high signal For the characteristics. 4 cases of lesion progression in imaging follow-up. 4 cases of midrib visible in the course of “V” fonts infarction. Three cases of MRA showed unilateral or bilateral posterior cerebral artery and its branches stenosis. Conclusion: Radiographic examination, especially MRI, is of great value in the early diagnosis and differential diagnosis of acute bilateral midline hypothalamic infarction syndrome.