中华神经医学杂志
中華神經醫學雜誌
중화신경의학잡지
CHINESE JOURNAL OF NEUROMEDICINE
2012年
9期
928-932
,共5页
陈蕾%张本恕%胡喜庆%吴潇哲%田志岩
陳蕾%張本恕%鬍喜慶%吳瀟哲%田誌巖
진뢰%장본서%호희경%오소철%전지암
帕金森叠加综合征%临床特点%核磁共振成像%正电子发射断层扫描
帕金森疊加綜閤徵%臨床特點%覈磁共振成像%正電子髮射斷層掃描
파금삼첩가종합정%림상특점%핵자공진성상%정전자발사단층소묘
Parkinson plus syndrome%Clinical feature%Magnetic resonance imaging%Positron emission tomography
目的 探讨帕金森叠加综合征的临床特点、影像学特点及鉴别要点. 方法 选择自2004年1月至2009年4月间在天津医科大学总医院和天津市环湖医院神经内科锥体外系门诊就诊的原发性帕金森病(IPD)、多系统萎缩(MSA)、路易小体痴呆(DLB)、进行性核上性麻痹(PSP)和皮质基底节变性(CBD)患者共172例进行研究.对所有入组患者进行详细的病史问卷调查、体格检查和头部CT/MRI检查,对部分研究对象采用了脑18F-FDG正电子发射断层扫描(PET)检查. 结果 (1)临床资料:各组患者主要临床特点除姿势异常外,差异均具有统计学意义(P＜0.05).(2)头MRI检查:59例MSA患者接受头MRI检查,其中MRI显示橄榄桥脑小脑萎缩48例(81.4％),T2加权像上的壳核低信号4例(6.8％),桥脑“十字征”30例(50.8％).15例PSP患者中3例(20.0％)头MRI正中矢状位显示中脑特征性“蜂鸟样”改变.全部6例CBD患者头MRI检查显示不对称的皮质萎缩(特别是额顶区),1例(16.7％)显示T2加权像上壳核低信号.(3)头部18F-FDG PET扫描:各组患者示踪剂分布存在差异. 结论 (1)各帕金森叠加综合征均有其特异性临床特点,可藉此与原发性帕金森病相鉴别.(2)头部MRI、18F-FDG PET检查可辅助诊断及鉴别IPD和帕金森叠加综合征.
目的 探討帕金森疊加綜閤徵的臨床特點、影像學特點及鑒彆要點. 方法 選擇自2004年1月至2009年4月間在天津醫科大學總醫院和天津市環湖醫院神經內科錐體外繫門診就診的原髮性帕金森病(IPD)、多繫統萎縮(MSA)、路易小體癡呆(DLB)、進行性覈上性痳痺(PSP)和皮質基底節變性(CBD)患者共172例進行研究.對所有入組患者進行詳細的病史問捲調查、體格檢查和頭部CT/MRI檢查,對部分研究對象採用瞭腦18F-FDG正電子髮射斷層掃描(PET)檢查. 結果 (1)臨床資料:各組患者主要臨床特點除姿勢異常外,差異均具有統計學意義(P＜0.05).(2)頭MRI檢查:59例MSA患者接受頭MRI檢查,其中MRI顯示橄欖橋腦小腦萎縮48例(81.4％),T2加權像上的殼覈低信號4例(6.8％),橋腦“十字徵”30例(50.8％).15例PSP患者中3例(20.0％)頭MRI正中矢狀位顯示中腦特徵性“蜂鳥樣”改變.全部6例CBD患者頭MRI檢查顯示不對稱的皮質萎縮(特彆是額頂區),1例(16.7％)顯示T2加權像上殼覈低信號.(3)頭部18F-FDG PET掃描:各組患者示蹤劑分佈存在差異. 結論 (1)各帕金森疊加綜閤徵均有其特異性臨床特點,可藉此與原髮性帕金森病相鑒彆.(2)頭部MRI、18F-FDG PET檢查可輔助診斷及鑒彆IPD和帕金森疊加綜閤徵.
목적 탐토파금삼첩가종합정적림상특점、영상학특점급감별요점. 방법 선택자2004년1월지2009년4월간재천진의과대학총의원화천진시배호의원신경내과추체외계문진취진적원발성파금삼병(IPD)、다계통위축(MSA)、로역소체치태(DLB)、진행성핵상성마비(PSP)화피질기저절변성(CBD)환자공172례진행연구.대소유입조환자진행상세적병사문권조사、체격검사화두부CT/MRI검사,대부분연구대상채용료뇌18F-FDG정전자발사단층소묘(PET)검사. 결과 (1)림상자료:각조환자주요림상특점제자세이상외,차이균구유통계학의의(P＜0.05).(2)두MRI검사:59례MSA환자접수두MRI검사,기중MRI현시감람교뇌소뇌위축48례(81.4％),T2가권상상적각핵저신호4례(6.8％),교뇌“십자정”30례(50.8％).15례PSP환자중3례(20.0％)두MRI정중시상위현시중뇌특정성“봉조양”개변.전부6례CBD환자두MRI검사현시불대칭적피질위축(특별시액정구),1례(16.7％)현시T2가권상상각핵저신호.(3)두부18F-FDG PET소묘:각조환자시종제분포존재차이. 결론 (1)각파금삼첩가종합정균유기특이성림상특점,가자차여원발성파금삼병상감별.(2)두부MRI、18F-FDG PET검사가보조진단급감별IPD화파금삼첩가종합정.
Objective To explore the clinical and imaging features of Parkinson plus syndromes and its differentiation points. Methods Seventy-three patients with idiopathic Parkinson's disease (IPD),68 patients with multiple system atrophy (MSA),10 patients with dementia of Lewy bodies (DLB),15 patients with progressive supranuclear palsy (PSP) and 6 patients with corticobasal degegnration (CBD) were recruited between January,2004 and April,2009 from our hospitals.All patients were given detailed investigation, physical examination, mini-mental status examination and brain CT/MRI examination.Part of patients were performed 18F-FDG PE.Statistical analysis was performed with SPSS 11.0 software. Results Except for postural abnormity, all the other main clinical features differed significantly between each 2 groups (P＜0.05).Brain MRI examination showed that Olivopontocerebellar atrophy was seen in 48 MSA patients (48/59,81.4％),putaminal hypointensities on T2-weighted images were seen in 4 MSA patients (4/59,6.8％) and the "hot cross bun" signal in pons was seen in 30 MSA patients (30/59, 50.8％); hummingbird-like changes were noted in midsagittal view of MRI in 3 PSP patients (3/15, 20.0％); all 6 CBD patients presented asymmetric cortical atrophy, especially in the frontoparietal areas,and 1 also presented putaminal hypointensities on T2-weighted image.Brain 18F-FDG PET indicated that 18F-FDG intake presented different distribution among groups. Conclusion Each atypical Parkinsonian syndrome has its specific clinical features which attribute to rule it out from either IPD or other Parkinson plus syndromes; brain MRI examination and 18F-PET scan can help to diagnose and differentiate Parkinson plus syndromes.
