成人低血糖脑病的MRI表现

摘要

目的 探讨成人低血糖脑病的MRI表现特征.方法 回顾性分析15例临床明确诊断为低血糖脑病患者的MRI表现；其中男6例,女9例；年龄34～79岁,平均53.8岁；全部患者行均进行常规MR序列(包括T1WI、T2WI、T2 FLAIR)和DWI检查.结果 15例低血糖患者颅脑MRI图像均发现异常信号,表现为斑片状、条状或脑回样；T1WI呈低信号,T2WI呈高信号,DWI呈明显高信号.病灶主要累及胼胝体压部、基底节、海马、黑质和大脑皮层,单侧或双侧对称性发病；其中胼胝体压部受累4例,基底节5例,单独累及尾状核头部1例,同时累及基底节、黑质、海马及大脑皮层5例.经治疗2周后3例复查MRI,病灶有明显吸收好转.结论 成人低血糖脑病发病部位及MRI信号表现具有一定的特征性,结合临床病史,可符合低血糖脑病的MRI表现；DWI序列对病灶非常敏感,呈高信号,应作为MRI检查首选序列.%Objective To determine the MRI features of adult hypoglycemic encephalopathy (HE).Methods Conventional MRI sequences including T1WI,T2WI,T2-FLAIR and DWI of 15 patients (6 men,9 women; mean age 53.8 years) with clinically diagnosed hypoglycemic encephalopathy were analyzed retrospectively.Results The MRI of all 15 patients showed unilateral or bilateral symmetrical patchy,stripe or gyral patterns of hypointensities on T1WI and hyperintensities on T2WI and DWI in the splenium of corpus callosum (4/15),head of caudate nucleus (1/15),basal ganglia,hippocampus,substantia nigra and cerebral cortex (5/15).Follow-up MRI after 2 weeks of treatment showed significant lesion absorption on 3/15 patients.Conclusion MRI of adult hypoglycemic encephalopathy shows characteristically edema with reduced diffusion in the corpus callosum,basal ganglia,hippocampus,substantia nigra and/or cerebral cortex.