Hwang Yang Ha, Suh Chung Kyu, Park Sung Pa
Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Korea.
J Korean Med Sci. 2003 Aug;18(4):621-4. doi: 10.3346/jkms.2003.18.4.621.
In a patient receiving 5-fluorouracil and levamisole, neurologic deficits suggest the cerebral demyelinating syndrome as a differential diagnosis. The authors report a patient diagnosed as multifocal inflammatory leukoencephalopathy for which thallium-201 (201Tl) single photon emission computed tomography (SPECT) and proton magnetic resonance spectroscopy (MRS) were employed as noninvasive diagnostic tools. 201Tl SPECT study was negative and proton MRS showed an increase of choline and lactate and well preserved N-acetylaspartate. These findings support histopathologic findings of multifocal inflammatory leukoencephalopathy revealing demyelination with relative axonal sparing in the patient.
在一名接受5-氟尿嘧啶和左旋咪唑治疗的患者中,神经功能缺损提示脑脱髓鞘综合征为鉴别诊断之一。作者报告了一名被诊断为多灶性炎性白质脑病的患者,为此采用了铊-201(201Tl)单光子发射计算机断层扫描(SPECT)和质子磁共振波谱(MRS)作为非侵入性诊断工具。201Tl SPECT研究结果为阴性,质子MRS显示胆碱和乳酸增加,而N-乙酰天门冬氨酸保存良好。这些发现支持了该患者多灶性炎性白质脑病的组织病理学结果,即显示有脱髓鞘且轴突相对保留。