CAJ | 학술논문

目的：探讨肥大性下橄榄核变性（ hypertrophic olivary degeneration ， HOD）的MRI信号及大小改变特征，以提高对该病的认识和诊断。方法收集继发于脑桥、小脑病变的HOD病例27例，原发病变位于脑桥25例，其中海绵状血管瘤1例，挫裂伤8例，高血压性出血14例，梗死2例；原发病变位于小脑2例，其中小脑挫裂伤1例，小脑出血1例。所有病例均行T1 WI、T2 WI、FLAIR、DWI，8例行SWI检查，分析HOD的信号特点，测量下橄榄核径线。结果 MRI表现为下橄榄核体积增大，T2 WI均呈高信号，14例DWI序列呈等信号，13例DWI序列呈稍高信号，所有病例FLAIR呈稍高信号，10例T1 WI呈等信号，17例T1WI呈稍低信号。病变下橄榄核平均横径为（6．94±0．67）mm，平均前后径为（6．69±0．83）mm，平均纵径为（16．95±1．20）mm，下橄榄核前缘与延髓前缘平均间距为（1．37±0．56）mm。结论 MRI能清晰显示下橄榄核肥大变性，正确认识该病，可避免漏诊及误诊。
목적：탐토비대성하감람핵변성（ hypertrophic olivary degeneration ， HOD）적MRI신호급대소개변특정，이제고대해병적인식화진단。방법수집계발우뇌교、소뇌병변적HOD병례27례，원발병변위우뇌교25례，기중해면상혈관류1례，좌렬상8례，고혈압성출혈14례，경사2례；원발병변위우소뇌2례，기중소뇌좌렬상1례，소뇌출혈1례。소유병례균행T1 WI、T2 WI、FLAIR、DWI，8례행SWI검사，분석HOD적신호특점，측량하감람핵경선。결과 MRI표현위하감람핵체적증대，T2 WI균정고신호，14례DWI서렬정등신호，13례DWI서렬정초고신호，소유병례FLAIR정초고신호，10례T1 WI정등신호，17례T1WI정초저신호。병변하감람핵평균횡경위（6．94±0．67）mm，평균전후경위（6．69±0．83）mm，평균종경위（16．95±1．20）mm，하감람핵전연여연수전연평균간거위（1．37±0．56）mm。결론 MRI능청석현시하감람핵비대변성，정학인식해병，가피면루진급오진。
Objective To study MRI signal characteristics and size change in hypertrophic olivary degeneration ( HOD) and improve the diagnosis of this disease .Methods Twenty-seven patients with HOD secondary to pons or cerebellar lesions were studied retrospectively.There were 25 cases with primary lesions located in pons, including cavernomas(1 case), trauma(8 cases), hyperten-sive hemorrhage(14 cases), and infarction(2 cases).The other 2 cases were with primary cerebellar lesions including trauma (1 case) and hemorrhage(1 case).Plain MRI scans were performed for all cases with T 1WI, T2WI, FLAIR, DWI sequence and 8 cases with SWI sequence additionally .MRI characteristics of HOD and the diameters of the affected olivary nucleus were observed .Results MRI scan revesled hyperophied olivary nucleus with increased T 2WI signal, iso-or slightly high signal intensity on DWI , slightly high inten-sity on FLAIR, iso-or slightly low signal intensity on T1WI.The average transverse diameter of the olivary nucleus was (6.94 ±0.67) mm, the average anterior posterior diameter was (6.69 ±0.83)mm, the average vertical diameter was (16.95 ±1.20)mm, the aver-age distance between anterior olivary nucleus margin and medulla anterior margin was (1.37 ±0.56) mm.Conclusions MRI can clearly demonstrate hypertrophic olivary degeneration , thus avoiding error or mistake .