CAJ | 학술논문

目的：研究探讨单发急性炎性脑脱髓鞘疾病的影像学特征及MRI、MRS在疾病诊断中的应用价值。方法选取我院近年来收治的单发急性炎性脑脱髓鞘疾病患者9例作为研究对象，回顾性分析患者的基本临床资料和影像学检查结果，并对其中枢神经系统的影像学征象进行分析，讨论其临床特征性。结果9例患者通过MRI诊断可见，1例患者病灶位于基底节区域，8例患者位于额顶叶皮层下白质，病灶边缘光滑，形状规则类圆形，结构层次典型，由病灶中心、环壁与水肿区构成，DWI和FLIAR、ADC图均为病变中心低信号，周边高信号；T1WI中心低信号，T2WI中心高信号。经增强扫描，病灶呈现出不规则的开环强化，且无显著占位效应。经MRS诊断，所有患者病变中心区域均有Cho峰增加(Cho/Cr增加)与NAA峰降低(NAA/Cr值降低)的表现。除此之外，3例患者有mI峰增加情况，5例患者有Cr峰降低情况。所有患者经相关治疗复查可见病灶体积、区域缩小，Cho峰降低和NAA峰恢复。结论单发急性炎性脑脱髓鞘疾病的患者经核磁共振检测，能清晰地观察到病灶的位置、数目、形态、信号特点等MRI表现，还可以在MRS诊断中准确显示NAA峰、Cho峰、Cr峰、mI峰的变化情况，帮助医生从患者的影像学征象的特征变化中准确诊断并判断疾病的进展。
목적：연구탐토단발급성염성뇌탈수초질병적영상학특정급MRI、MRS재질병진단중적응용개치。방법선취아원근년래수치적단발급성염성뇌탈수초질병환자9례작위연구대상，회고성분석환자적기본림상자료화영상학검사결과，병대기중추신경계통적영상학정상진행분석，토론기림상특정성。결과9례환자통과MRI진단가견，1례환자병조위우기저절구역，8례환자위우액정협피층하백질，병조변연광활，형상규칙류원형，결구층차전형，유병조중심、배벽여수종구구성，DWI화FLIAR、ADC도균위병변중심저신호，주변고신호；T1WI중심저신호，T2WI중심고신호。경증강소묘，병조정현출불규칙적개배강화，차무현저점위효응。경MRS진단，소유환자병변중심구역균유Cho봉증가(Cho/Cr증가)여NAA봉강저(NAA/Cr치강저)적표현。제차지외，3례환자유mI봉증가정황，5례환자유Cr봉강저정황。소유환자경상관치료복사가견병조체적、구역축소，Cho봉강저화NAA봉회복。결론단발급성염성뇌탈수초질병적환자경핵자공진검측，능청석지관찰도병조적위치、수목、형태、신호특점등MRI표현，환가이재MRS진단중준학현시NAA봉、Cho봉、Cr봉、mI봉적변화정황，방조의생종환자적영상학정상적특정변화중준학진단병판단질병적진전。
Objective Study investigated the characteristics and MRI imaging single acute inflammatory demyelinating disease of the brain, MRS applications in disease diagnosis. Methods Admitted to our hospital in recent years, single acute inflammatory demyelinating disease of the brain in patients with nine cases for the study, the basic clinical data and imaging findings were retrospectively analyzed patients and analyzed for signs of central nervous system imaging discuss its clinical characteristic. Results By MRI diagnosis of basal ganglia lesions in one case, the white matter is located eight cases, the lesion edges smooth, round shape rules, hierarchy typical. DWI and FLIAR, ADC figure are low signal lesion center, the surrounding high signal;T1WI center of low signal, T2WI high signal center. Through enhanced scan showed irregular lesions strengthening the open-loop and no significant mass effect. After MRS diagnosis, al patients had lesions in the central region increased Cho and NAA peak lower peak performance. Three patients had a peak increase in mI, 5 patients had lower Cr peak condition. Review of al patients seen by the relevant treatment lesion volume, area shrink, Cho and NAA peak reduce peak recovery. Conclusion Patients with single acute inflammatory demyelinating disease of the brain detected by MRI, the lesion can be clearly observed in the location, number, morphology, signal characteristics, such as MRI performance, but also can accurately display the NAA peak in the MRS diagnosis, Cho peak, changes Cr peak, mI peak, to help doctors accurately diagnose and determine the progress of the disease in patients from the characteristic radiographic signs of.