摘要
目的 分析43例临床可能或很可能克-雅病（CJD）患者的影像学特征,为临床一线应用磁共振成像（MRI）诊疗CJD提供可借鉴的资料和经验.方法 收集2013年1月至2015年11月以“可疑CJD”诊断在首都医科大学宣武医院神经内科住院的患者,对患者一般资料及MRI的特征进行回顾性分析.结果 以“可疑CJD”收入院的62例患者,出院时分别诊断为很可能CJD和可能CJD患者共43例,其典型MRI特征是弥散加权成像（DWI）序列沿皮质走行的“飘带征”和（或）双侧基底节区高信号,其中单纯皮质受累者（76.47％,26/34）,其次为大脑皮质和基底节同时受累者（23.53％,8/34）.MRI阳性组与阴性组的临床表现相比,阳性组锥体外系症状更加突出（26/31比9/12,P=0.015）,未发现MRI阳性组内单纯皮质受累组与皮质基底节同时受累组的临床特征间的差异（P＞0.05）.结论 CJD患者的MRI有特征性变化,且在疾病的不同阶段随病情进展发生相应改变.结合临床评估病情进展,通过定期复查MRI可间接推测大脑微观病理变化.
Objective To assess the imaging features of 43 patients diagnosed as clinically possible or probable Creutzfeldt-Jakob disease （CJD） for providing referential information and experience on applications of MRI in the clinical diagnosis and treatment of CJD.Method All patients who were diagnosed with ＂suspected CJD＂ and hospitalized in Xuanwu Hospital from January 2013 to November 2015 were collected,and their clinical information and MRI imaging features were analyzed retrospectively.Results Totally 62 patients with ＂suspected CJD＂ were rectruited in this study,and 43 of them were diagnosied as probable and possible CJD when they were discharged.The typical MRI feature of CJD patients was ＂cortical ribbon＂ sign in MR DWI sequences and/or high signal in cortex or bilateral basal ganglia.In all patients,the simple coritcal involvement was the highest（76.47%,26/34）,followed by the cortical cortex and basal ganglia （23.53%,8/34）.MRI positive group had more prominent extrapyramidal symptoms than MRI negative group （26/31 vs 9/12,P =0.015）,but no statistical difference in clinic feature was found between the group with simple cortex affected and the group with both cortex and bilateral basal ganglia affected （P 〉 0.05）.Conclusions MRI images of patients with CJD have special characteristics and have corresponding changes when the patients are in different stages of disease.In combination with the clinical evaluation of disease progression,brain microscopic pathological changes of CJD patients can be assessed by regularly brain MRI examination.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2016年第39期3142-3145,共4页
National Medical Journal of China
基金
国家自然科学基金（81301138）
国家863计划（2015AA020514）
中国博士后科学基金（200902119）
新世纪百千万人才工程北京市级人选（2010-005）
北京市卫生系统高层次卫生技术人才培养项目（2009-3-53）
关键词
克-雅病
磁共振成像
飘带征
Creutzfeldt-Jakob disease
Magnetic resonance imaging
＆quot
cortical ribbon＆quot
sign
作者简介
通信作者：王红星，Email：hxwang8888@126．com
