摘要
目的探讨亚急性1,2-二氯乙烷(1,2-Dichloroethane,1,2-DCE)中毒性脑病的影像学表现,提高对本病的认识。方法对2014年2月—2016年4月在温州医科大学附属第二医院和温州医科大学附属苍南医院12例1,2-DCE中毒性脑病患者的CT、MR影像学表现及特征作回顾性分析。结果 CT表现:两侧大脑半球白质区广泛性对称性密度减低,边缘模糊,皮髓质分界不清,脑回肿胀,脑沟变浅;两侧苍白球、内囊后肢、外囊及丘脑密度减低,脑干肿胀,密度减低,周围脑池受压变窄;两侧小脑齿状核斑片状密度减低。MR表现:两侧大脑皮层下弓形白质纤维区广泛性对称性"U"形T_1WI低信号、T_2WI、T_2-FLAIR高信号,伴脑回变窄、脑沟变浅或消失,未见累及半卵圆中心区;两侧豆状核、外囊、小脑齿状核也呈条片状、小片状T_1WI低信号、T_2WI、T_2-FLAIR高信号影。DWI序列上述病变区呈明显高信号,边界较清,ADC呈低信号。结论亚急性1,2-DCE中毒性脑病具有特定的发病环境和突发性头痛、意识障碍为主的临床症状,MR检查比CT能更敏感地反映病变累及的部位、范围、水肿类型及严重程度,并具有一定的特征性,为临床及时、准确诊断中毒性脑病提供重要依据。
Objective To investigate imaging characteristics in patients with subchronic toxic encephalopathy induced by1,2-dichloroethane（ 1,2-DCE） and to improve the understanding of this disease. Methods CT and MRI findings of 12 patients with toxic encephalopathy induced by 1,2-DCE in the Second Affiliated Hospital of Wenzhou Medical University and Cangnan Hospital were retrospective study. Results CT manifestations： bilateral hemisphere white matter showed generalized and symmetry low density,blurred edge,not clear boundary between cortex and medulla,swelling gyrus,shallow groove; decreased density of bilateral globus pallidus,hind limb of the internal capsule,external capsule and thalamus;swelling brain stem and decreased density,the surrounding cisterns get narrowed by the compression; Bilateral cerebellar dentate nuclei presenting patchy and low density. MRI performance： bilateral subcortical arcuate fasciculus showed generalized and symmetric＂U＂shape T1 WI low signal,and T2 WI,T2-Fl AIR high signal,with gyrus narrowed and sulcus variable shallow or disappeared. Centrum semiovale was not involved in. Bilateral lentiform nucleus,external capsule,cerebellar dentate nuclei also showed that T1 WI has stripes or small flake signal,T2 WI and T2-FLAIR had high signal. The signal of lesions area was significantly high and boundary was relatively clear in DWI sequence,whose signal was low in ADC.Conclusion The onset of Subchronic 1,2-DEC toxic encephalopathy has a specific environmental and clinical symptoms of sudden headache and the disturbance of consciousness. MR is more sensitive to the involved parts,scope,type and severity of edema as compared with CT. The certain characteristics will provide important evidence for the accurate diagnosis in time.
出处
《中华全科医学》
2017年第2期311-313,共3页
Chinese Journal of General Practice
基金
浙江省苍南县科技计划项目(2015S26)
关键词
二氯乙烷
中毒性脑病
体层摄影术
X线计算机
磁共振成像
Ethylene dichloride
Toxic encephalopathy
Tomography
X-ray computer
Magnetic resonance imaging
