CAJ | 학술논문

目的：探讨恶性肿瘤并发 Wernicke 脑病患者的早期诊断。方法回顾性分析4例恶性肿瘤并发Wernicke 脑病患者的临床、影像学资料。结果4例患者中源于白血病2例，胃癌1例，小肠间质瘤1例，病前均有硫胺素摄入不足病史。临床均表现为不同程度的精神、意识障碍及运动功能障碍（包括四肢无力，站立、行走困难），头颅 MR 平扫显示 T1WI 低信号、T2WI 高信号、FLAIR 高信号的异常信号影，多对称分布在中线结构如中脑导水管、第三脑室、第四脑室的周围及乳头体。3例患者经补充大剂量硫胺素后症状迅速好转，1例放弃治疗。结论详细的病史、典型的临床表现以及头颅 MR 检查能为恶性肿瘤并发 Wernicke 脑病患者的早期诊断提供帮助，及早补充大剂量硫胺素是治疗的关键。
목적：탐토악성종류병발 Wernicke 뇌병환자적조기진단。방법회고성분석4례악성종류병발Wernicke 뇌병환자적림상、영상학자료。결과4례환자중원우백혈병2례，위암1례，소장간질류1례，병전균유류알소섭입불족병사。림상균표현위불동정도적정신、의식장애급운동공능장애（포괄사지무력，참립、행주곤난），두로 MR 평소현시 T1WI 저신호、T2WI 고신호、FLAIR 고신호적이상신호영，다대칭분포재중선결구여중뇌도수관、제삼뇌실、제사뇌실적주위급유두체。3례환자경보충대제량류알소후증상신속호전，1례방기치료。결론상세적병사、전형적림상표현이급두로 MR 검사능위악성종류병발 Wernicke 뇌병환자적조기진단제공방조，급조보충대제량류알소시치료적관건。
Objective To investigate the early diagnosis of maglinant tumor complicated by Wernicke encephalopathy patients.Methods The clinical and imaging characteristics of 4 cases of Wernicke encephalopathy were analyzed retrospec -tively.Results Among 4 patients,there were 2 cases of leukemia,1 case of gastric cancer,1 case of intestinal stormal tumor, All patients had inadequate intake of thiamine before onset .The clinical characteristics of Wernicke encephalopathy were dif -ferent dagree psychiatric and mental disorder ,motor function disorder (including extremities weakness ,standing and walking difficulty).In cranial MR, all cases were found low signals on T1 weighted images (T1WI) and high signals on T2WI and FLAIR in the third and fourth cerebral ventricles , aqueduct of midbrain, and bulla of fornix.3 cases with thiamine supple-mentation were significantly improved .1 case gave up treatment.Conclusion Detail history taking, the typical clinical mani-festations and cranial MR findings are important for early diagnosis of malignant brain disease complicated by Wernicke , early high-dose thiamine supplements is the key to treatment .