南昌大学学报（医学版）
南昌大學學報（醫學版）
남창대학학보（의학판）
ACTA ACADEMIAE MEDICINAE JIANGXI
2014年
9期
46-49
,共4页
一氧化碳中毒%磁共振%扩散加权成像
一氧化碳中毒%磁共振%擴散加權成像
일양화탄중독%자공진%확산가권성상
carbon monoxide poisoning%magnetic resonance%diffusion weighted imaging imaging
目的：探讨一氧化碳中毒（COP）性脑病的磁共振弥扩散加权成像（MQ-DWI）表现与预后的关系。方法对34例COP 性脑病患者的磁共振影像学、临床表现及预后进行回顾性分析。结果所有患者均及时给于高压氧和药物对症治疗。13例轻度中毒者经临床治疗后均痊愈，随访1～2个月无异常；5例中度中毒者随访3～6个月，其中1例出现迟发性脑病，4例痊愈；16例重度中毒者随访3～6个月，13例出现 COP 迟发性脑病（4例死亡），3例痊愈。影像学表现：单纯基底节区受累（10例）及单纯脑皮层受累（2例）患者，MR 表现均表现为对称性稍长 T1稍长 T2信号，均痊愈；单纯脑白质受累（3例），MR 表现为双侧大脑白质内对称性稍长 T1稍长 T2信号，DWI 为稍高信号，2例痊愈，1例出现迟发性脑病；双侧基底节区及脑白质或双侧基底节区及脑皮层同时受累（16例），MR 表现为受累区域对称性稍长 T1稍长 T2信号，FLAIR 序列及 DWI 均为高信号，3例痊愈，13例出现 COP 迟发性脑病（4例死亡）；MR 表现为正常3例，FLAIR 序列及 DWI 未见明显高信号，均痊愈。结论MR-DWI 对 COP 性脑病患者的预后判断有重要的临床价值，DWI 信号越高，预示着脑白质脱髓鞘改变越严重、发生迟发性脑病的概率越大、临床预后也越差。
目的：探討一氧化碳中毒（COP）性腦病的磁共振瀰擴散加權成像（MQ-DWI）錶現與預後的關繫。方法對34例COP 性腦病患者的磁共振影像學、臨床錶現及預後進行迴顧性分析。結果所有患者均及時給于高壓氧和藥物對癥治療。13例輕度中毒者經臨床治療後均痊愈，隨訪1～2箇月無異常；5例中度中毒者隨訪3～6箇月，其中1例齣現遲髮性腦病，4例痊愈；16例重度中毒者隨訪3～6箇月，13例齣現 COP 遲髮性腦病（4例死亡），3例痊愈。影像學錶現：單純基底節區受纍（10例）及單純腦皮層受纍（2例）患者，MR 錶現均錶現為對稱性稍長 T1稍長 T2信號，均痊愈；單純腦白質受纍（3例），MR 錶現為雙側大腦白質內對稱性稍長 T1稍長 T2信號，DWI 為稍高信號，2例痊愈，1例齣現遲髮性腦病；雙側基底節區及腦白質或雙側基底節區及腦皮層同時受纍（16例），MR 錶現為受纍區域對稱性稍長 T1稍長 T2信號，FLAIR 序列及 DWI 均為高信號，3例痊愈，13例齣現 COP 遲髮性腦病（4例死亡）；MR 錶現為正常3例，FLAIR 序列及 DWI 未見明顯高信號，均痊愈。結論MR-DWI 對 COP 性腦病患者的預後判斷有重要的臨床價值，DWI 信號越高，預示著腦白質脫髓鞘改變越嚴重、髮生遲髮性腦病的概率越大、臨床預後也越差。
목적：탐토일양화탄중독（COP）성뇌병적자공진미확산가권성상（MQ-DWI）표현여예후적관계。방법대34례COP 성뇌병환자적자공진영상학、림상표현급예후진행회고성분석。결과소유환자균급시급우고압양화약물대증치료。13례경도중독자경림상치료후균전유，수방1～2개월무이상；5례중도중독자수방3～6개월，기중1례출현지발성뇌병，4례전유；16례중도중독자수방3～6개월，13례출현 COP 지발성뇌병（4례사망），3례전유。영상학표현：단순기저절구수루（10례）급단순뇌피층수루（2례）환자，MR 표현균표현위대칭성초장 T1초장 T2신호，균전유；단순뇌백질수루（3례），MR 표현위쌍측대뇌백질내대칭성초장 T1초장 T2신호，DWI 위초고신호，2례전유，1례출현지발성뇌병；쌍측기저절구급뇌백질혹쌍측기저절구급뇌피층동시수루（16례），MR 표현위수루구역대칭성초장 T1초장 T2신호，FLAIR 서렬급 DWI 균위고신호，3례전유，13례출현 COP 지발성뇌병（4례사망）；MR 표현위정상3례，FLAIR 서렬급 DWI 미견명현고신호，균전유。결론MR-DWI 대 COP 성뇌병환자적예후판단유중요적림상개치，DWI 신호월고，예시착뇌백질탈수초개변월엄중、발생지발성뇌병적개솔월대、림상예후야월차。
Objective To investigate the correlation between diffusion weighted magnetic reso-nance imaging(MRI)manifestations and prognosis in carbon monoxide poisoning(COP)encepha-lopathy.Methods MRI manifestations,clinical features and prognosis of 34 patients with COP encephalopathy were analyzed retrospectively.Results All patients were timely given hyperbaric oxygen and symptomatic drug treatment.Among the 34 patients,13 patients with mild poisoning were cured and showed no abnormalities after 1-2 months of follow-up.Among the 5 patients with moderate poisoning who were followed up for 3-6 months,1 had delayed encephalopathy and 4 were cured.Among the 16 patients with severe poisoning who were followed up for 3-6 months, 13 had delayed encephalopathy(4 died)and 3 were cured.MRI showed symmetrically slightly long T1 and T2 signals in 10 patients with basal ganglia involvement and 2 patients with cerebral corti-cal involvement (all of them were cured),symmetrically slightly long T1 and T2 signals and slightly high DWI signal in bilateral white matter in 3 patients with white matter involvement(2 were cured and 1 had delayed encephalopathy),symmetrically slightly long T1 and T2 signals and high FLAIR and DWI signals in the involved area in 16 patients with simultaneous involvement of bilateral basal ganglia and cerebral white matte or bilateral basal ganglia and cerebral cortex(3 were cured and 13 had delayed encephalopathy),and normal without high FLAIR and DWI sig-nals in 3 patients(all of them were cured).Conclusion Diffusion weighted MRI is of great clinical value in determining the prognosis of patients with COP encephalopathy.The DWI signal is posi-tively correlated with cerebral white matter demyelination and delayed encephalopathy,but nega-tively correlated with clinical prognosis in patients with COP encephalopathy.
