Suzuki Masahiro, Koide Reiji, Kagamihara Yasuhiro, Yagishita Akira, Hayashi Hideaki
Department of Neurology, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu, Tokyo 183-0042, Japan.
No To Shinkei. 2004 Jan;56(1):77-81.
We report a 54-year-old female with rheumatoid factor-positive hypertrophic cranial pachymeningitis. At age of 51 years she developed headache, hearing loss, right vagal nerve palsy, and right accessory nerve palsy. MRI revealed thickening and gadolinium-enhancement of the cranial dura mater. The initial symptoms significantly improved with corticosteroid therapy. Two years later, she presented with severe headache and neck pain. Although gadolinium-enhanced MR images failed to show any change compared with those before recurrence, 201Tl single-photon emission CT (SPECT) showed a remarkable accumulation of thallium-201 in the dura mater. Furthermore, the abnormal uptake of thallium-201 returned to normal after treatment with corticosteroid. 201T1-SPECT was a useful tool for the evaluation of disease activity in the patient with hypertrophic pachymeningitis.
我们报告一例54岁类风湿因子阳性的肥厚性硬脑膜炎女性患者。51岁时，她出现头痛、听力丧失、右侧迷走神经麻痹和右侧副神经麻痹。MRI显示硬脑膜增厚并伴有钆增强。初始症状经皮质类固醇治疗后显著改善。两年后，她出现严重头痛和颈部疼痛。尽管钆增强MR图像与复发前相比未显示任何变化，但201铊单光子发射计算机断层扫描（SPECT）显示硬脑膜中有明显的201铊积聚。此外，经皮质类固醇治疗后，201铊的异常摄取恢复正常。201T1-SPECT是评估肥厚性硬脑膜炎患者疾病活动度的有用工具。
