Nakamura T, Makino M, Ebisu T, Nakase T, Umeda M, Tanaka C, Nakajima K
Department of Neurology, Research Institute for Neurological Diseases and Geriatrics, Kyoto Prefectural University of Medicine.
No To Shinkei. 1999 Feb;51(2):145-8.
We report an 84-year-old woman with medial medullary syndrome diagnosed by diffusion-weighted magnetic resonance imaging (MRI). She was admitted because of left hemiparesis and hypesthesia. T2-weighted and diffusion-weighted MRI showed a high signal lesion at the right medial medulla oblongata 10 days after the onset. It is well known that diffusion-weighted MRI is useful for detecting supratentrial cerebral ischemic lesions in the extremely acute stage. However, to our knowledge, there have been only a few reports of diffusion-weighted MRI in patients with ischemic stroke of the medulla oblongata. Normal nerve fibers in the direction perpendicular to the motion-probing gradient (MPG) shows a high signal by diffusion-weighted MRI (anisotropy of apparent diffusion cofficient [ADC]). Normal nerve fibers in the pyramidal tract of medulla oblongata also shows a high signal when the MPG pulse is applied in the x and y directions. We solved this problem by using isotropic diffusion-weighted imaging and were able to detect ischemic lesion of medial medullary infarction in the acute phase.
我们报告了一例通过扩散加权磁共振成像（MRI）诊断为内侧延髓综合征的84岁女性。她因左侧偏瘫和感觉减退入院。发病10天后，T2加权和扩散加权MRI显示右侧延髓内侧有一个高信号病变。众所周知，扩散加权MRI有助于在超急性期检测幕上脑缺血性病变。然而，据我们所知，关于延髓缺血性中风患者的扩散加权MRI报道很少。垂直于运动探测梯度（MPG）方向的正常神经纤维在扩散加权MRI上显示高信号（表观扩散系数[ADC]的各向异性）。当在x和y方向施加MPG脉冲时，延髓锥体束中的正常神经纤维也显示高信号。我们通过使用各向同性扩散加权成像解决了这个问题，并能够在急性期检测到内侧延髓梗死的缺血性病变。
