摘要
目的探讨心肺复苏后缺血缺氧性脑病的MRI表现与临床特点。方法对经我院急诊的35例行心肺复苏抢救成功的心搏骤停患者的颅脑MRI图像及临床资料回顾性分析。结果 35例颅脑MRI表现均有不同程度信号异常、脑肿胀,呈大致对称分布,其中位于小脑2例、基底节3例、丘脑3例、大脑皮层5例,小脑、基底节、丘脑、大脑半球都累及者22例,表现为T_1WI呈略低信号,T_2WI、T_2WI/FLAIR呈稍高信号,DWI呈高信号,ADC图呈低信号,伴或不伴脑沟变窄,部分脑回增粗或变窄,脑室系统、脑池有或无异常增宽或变窄、未见信号异常。临床表现:神志不清,不同程度昏迷,反应迟钝,四肢肌张力增高,瞳孔等大,光反应存在。结论心肺复苏后缺血缺氧性脑病的MRI表现具有一定特征性,对早期诊断、判断预后具有一定优势,MRI是目前比较可靠、敏感的影像学检查方法。
Objective To investigate the MRI features and the clinical features of hypoxic ischemic cncephalopathy aider cardiopulmonary resuscitation. Methods The brain MRI images and clinical data of 35 patients with sudden arrest of heart beat, who were rescued successfully by emergency treatment with cardiopuhnonary resuscitation in our hospital, were retrospectively analyzed. Results The brain MRI of those 35 cases showed various degrees of abnormal signal, brain swelling, roughly presenting with a symmetrical distribution, in which 5 cases were located in the cerebellum, 2 cases in basal ganglia, 3 cases in thalamus and the cerebral cortex. 22 cases were involved in cerebellum, basal ganglion, thalamus and the cerebral hemispheres, in whom T^WI showed slightly low signal, T2WI, T2WI/FLAIR showed slightly high signal, DWI showed high signal, the ADC maps showed low signal, with or without sulci narrowing. Gyri were shown partially as widened or nan＇owed signs, with or without anom- alously wide or narrow in ventricle and cistern, as well as no appearance of abnormal signal. Clinical manifestations included un- consciousness, coma in different degree, unresponsive status, hypermyotonia of limbs, equal size of both pupils （isocoria） , with normal light reaction. Conclusion The MRI features of hypoxic ischemic encephalopathy after cardiopulmonary resuscitation have certain characteristics, which has certain advantages in early diagnosis and prognosis. MRI is a reliable and sensitive imaging method.
出处
《医学影像学杂志》
2016年第8期1376-1378,共3页
Journal of Medical Imaging
关键词
心肺复苏
心搏骤停
脑
缺血缺氧
磁共振成像
Cardiopulmonary resuscitation
Cardiac arrest
Cerebral ischemia
Hypoxia
Magnetic resonance imaging
