摘要
目的分析CO中毒性脑病的临床及影像学表现特征。方法回顾性分析我院2016年1月~2017年6月临床确诊的25例CO中毒性脑病的临床及影像学资料。所有患者均有2次及以上CT和(或)MRI检查资料。结果CO中毒性脑病临床表现主要包括头痛、智能及认知功能障碍、精神症状、锥体外系功能障碍、肢体功能障碍、昏迷等。本组CT及MRI表现:单纯基底节受累(n=12),单纯脑皮层受累(n=1),基底节和脑白质同时受累(n=4),基底节区及脑皮层同时受累(n=5),基底节区、脑皮层和脑白质同时受累(n=3)。伴发病变:伴急性大面积出血性脑梗死1例,伴急性中耳乳突炎8例。本组MRI在显示病变范围及损伤程度方面较CT更为直观准确,影像学随访还较好地评价病变治疗后变化及转归。结论 CO中毒性脑病表现为以急性痴呆为特征的一系列神经精神症状及体征,其影像学尤其是MRI表现具有一定特征性,CT及MRI在该病的诊断、鉴别诊断及预后评价中具有重要价值。
Objective To analyze the clinical and imaging characteristics of carbon monoxide poisoning encephalopathy.Methods The clinical and imaging data of25cases of carbon monoxide poisoning encephalopathy diagnosed in our hospital from January2016to June2017were retrospectively analyzed.All patients had CT and/or MRI data for2or more than2times.Results Clinical manifestations included headache,intelligence and cognitive dysfunction,psychiatric symptoms,extrapyramidal dysfunction,limb dysfunction,and coma.The CT and MRI manifestation included simple basal ganglia involvement(n=12),simple cerebral cortex involvement(n=1),basal ganglia combined with white matter involvement(n=4),basal ganglia and cerebral cortex involvement(n=5)and basal ganglia and cerebral cortex,white matter involvement(n=3).There was1case of acute large area hemorrhagic cerebral infarction,and8cases of acute middle ear mastoiditis.MRI of this group was more intuitive and accurate than CT in showing the range of lesions and the degree of damage.The follow-up imaging also assessed changes and outcome of disease after treatment.Conclusion Carbon monoxide poisoning encephalopathy manifested as a series of neuropsychiatric symptoms and signs characterized by acute dementia.The imaging feature,especially MRI feature,has a certain characteristic.CT and MRI have important value in the diagnosis,differential diagnosis and prognosis of the disease.
作者
司艳红
丁长青
孙惠芳
张玉娜
赵辉
SI Yanhong;DING Changqing;SUN Huifang;ZHANG Yu na;ZHAO Hui(Department of Neurology, Fengxian People's Hospital in Jiangsu Province, Fengxian 221700, China;Department of Radiology, Fengxian People's Hospital in Jiangsu Province, Fengxian 221700, China)
出处
《中国现代医生》
2017年第31期29-34,共6页
China Modern Doctor
基金
江苏省卫生厅医学科研立项课题(YG201419)
第一批"徐州市医学青年后备人才培养工程"资助(徐卫科教[2014]3号)
关键词
一氧化碳中毒
脑病
螺旋CT
磁共振成像
Carbon monoxide poisoning
Encephalopathy
Spiral CT
Magnetic resonance imaging
