Koyama Masamichi, Yagishita Akira, Nakata Yasuhiro, Hayashi Masaharu, Bandoh Mitsuaki, Mizutani Toshio
Department of Neuroradiology, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu, Tokyo, 183-0042, Japan.
Neuroradiology. 2007 Nov;49(11):905-12. doi: 10.1007/s00234-007-0265-6. Epub 2007 Jul 14.
Diagnosing corticobasal degeneration is often difficult on the basis of clinical symptoms and radiological images. We aimed to clarify the imaging findings of corticobasal degeneration syndrome (CBDS).
Included in the study were 16 patients (8 men, 8 women, 46-75 years old) with clinically diagnosed CBDS. We evaluated the patients' symptoms and signs, and MR and single-photon emission CT (SPECT) imaging findings.
All the patients had cerebral atrophy. Asymmetric cerebral atrophy was observed in 13 patients (81%) predominantly contralateral to the side clinically more affected. Atrophy in the cerebral peduncle was observed in seven patients. FLAIR images showed hyperintensity in the subcortical white matter in the frontoparietal lobes in the clinically more affected side in 14 patients, and in the rolandic region in 13 patients. Asymmetric hypoperfusion in the frontoparietal lobes on SPECT images was observed in all of the patients, and in the basal ganglia in 11 patients.
CBDS might be unique in showing hyperintensity in the subcortical white matter in the rolandic region on FLAIR images with asymmetric atrophy predominantly contralateral to the side clinically more severely affected. Asymmetric atrophy in the cerebral peduncle without signal abnormalities was also characteristic of CBDS. Atrophy in the midbrain tegmentum was also seen in patients with CBDS.
基于临床症状和影像学图像诊断皮质基底节变性往往很困难。我们旨在阐明皮质基底节变性综合征(CBDS)的影像学表现。
本研究纳入了16例临床诊断为CBDS的患者(8例男性,8例女性,年龄46 - 75岁)。我们评估了患者的症状和体征,以及磁共振成像(MR)和单光子发射计算机断层扫描(SPECT)的影像学表现。
所有患者均有脑萎缩。13例患者(81%)观察到不对称性脑萎缩,主要位于临床症状较重一侧的对侧。7例患者观察到大脑脚萎缩。液体衰减反转恢复序列(FLAIR)图像显示,14例患者临床症状较重一侧的额顶叶皮质下白质呈高信号,13例患者中央沟区域呈高信号。所有患者的SPECT图像均显示额顶叶不对称性灌注减低,11例患者基底节区也有灌注减低。
CBDS可能具有独特的影像学表现,即FLAIR图像上中央沟区域皮质下白质呈高信号,且不对称性萎缩主要位于临床症状较重一侧的对侧。大脑脚不对称性萎缩且无信号异常也是CBDS的特征。CBDS患者中脑被盖也可见萎缩。