CAJ | 학술논문

目的探讨原发性中枢神经系统血管炎的临床和影像学表现,以明确诊断要点.方法临床或病理证实的中枢神经系统血管炎8例,其中男性3例,女性5例.年龄从19～73不等,平均年龄40.3岁.全部行MRI检查,其中增强4例;8例行MRA检查,分析所有病例的临床资料和MR片.结果 8例PACNS中,8例位于幕上,以额叶及顶叶多见,其中3例为双侧多发;幕下4例位于脑干及脊髓.影像学上,多数病灶边界模糊,与相应血管分布区一致,累及灰质和白质,但以白质为主,可有水肿,增强后有不同程度增强,呈斑片样或脑回样,甚至呈结节样,类似肿瘤.血管成像可以发现血管炎的征象.结论原发性中枢神经系统血管炎的临床和影像学表现多样,MRI具有一定价值,MRA及DSA对诊断帮助较大,确诊需要活检病理证实.
목적 탐토원발성중추신경계통혈관염적림상화영상학표현,이명학진단요점.방법 림상혹병리증실적중추신경계통혈관염8례,기중남성3례,녀성5례.년령종19～73불등,평균년령40.3세.전부행MRI검사,기중증강4례;8례행MRA검사,분석소유병례적림상자료화MR편.결과 8례PACNS중,8례위우막상,이액협급정협다견,기중3례위쌍측다발;막하4례위우뇌간급척수.영상학상,다수병조변계모호,여상응혈관분포구일치,루급회질화백질,단이백질위주,가유수종,증강후유불동정도증강,정반편양혹뇌회양,심지정결절양,유사종류.혈관성상가이발현혈관염적정상.결론 원발성중추신경계통혈관염적림상화영상학표현다양,MRI구유일정개치,MRA급DSA대진단방조교대,학진수요활검병리증실.
Objective To study the clinical and imaging feature of primary angiitis of the central nervous system(PACNS),in order to find the key point of diagnosis.Materials and Methods Pathological or clinical proved PACNS 9 cases,3 men and 5 women,ranging from 19～73 years old with average 40.2 years old.All were examined with MRI and 4 by enhanced scan:8 with MRA and 2 with DSA.Clinical information and all films(MRI and DSA)were analyzed.Results In 8 cases of PACNS,1cases were proved by operation or biopsy,and 7 cases were proved by clinical follow-up.8 cases were located supratentorial,most were in frontal lobe,3 cases were multiple focuses in both sides;4 cases were located infratentorial and brain sten and spinal.On imaging,most focuses were with blurry margin,and the regions were accordant with that of the blood vessel.The lesions involved gray matter and white matter,but mostly in white matter,edema could be seen in some cases.Different grade of enhancement could be seen,the enhancement may be patchy or convolutional,even nodulous witch was resemble with tumor.The sign of angiitis could be seen in angiography.Conclusion The clinical and imaging features of PACNS are various,CT and MRI ale valuable,MRA and DSA are helpful in diagnosis,but the diagnosis must given by pathological examination.