Henkes H, Bittner R, Huber G, Sperner J, Heye N, Bassir C, Piepgras U
Institut für Neuroradiologie, Medizinische Fakultät, Universität des Saarlandes, Homburg/Saar.
Radiologe. 1991 Jun;31(6):289-96.
Clinical presentation of a child with port-wine stain and seizures leads to the suspicion of Sturge-Weber disease (SWD). This diagnosis can be confirmed by the detection of a meningeal angiomatosis. In rare cases, early detection of meningeal pathology by ultrasound has been reported. Key findings are brain atrophy, gyriform cortical calcifications demonstrated by skull radiographs after the first year of life or earlier by cranial CT, and dys- or aplasia of the deep cerebral veins on angiography. Radionuclide imaging shows focal or diffuse tracer accumulation over the affected brain regions. MR demonstrates an abnormal appearance of the affected meninges, especially thickening and pathologically increased signal intensity after Gd-DTPA application. This, in association with the demonstration of abnormal enhancement in deep medullary veins, is the most characteristic finding. Contrast-enhanced MR allows early and non-invasive diagnosis of SWD, mainly by revealing leptomeningeal angiomatosis and abnormal venous vessels.
一名患有葡萄酒色斑和癫痫发作的儿童的临床表现引发了对斯特奇-韦伯综合征(SWD)的怀疑。通过检测脑膜血管瘤病可确诊该疾病。在罕见情况下,已有通过超声早期检测脑膜病变的报道。关键发现包括脑萎缩、出生后第一年或更早通过颅骨X线平片显示的脑回状皮质钙化,或更早通过头颅CT显示,以及血管造影显示大脑深部静脉发育异常或发育不全。放射性核素成像显示在受影响的脑区有局灶性或弥漫性示踪剂积聚。磁共振成像(MR)显示受影响脑膜外观异常,尤其是在应用钆喷酸葡胺(Gd-DTPA)后增厚且病理信号强度增加。这与深部髓质静脉异常强化的表现相关,是最具特征性的发现。增强磁共振成像主要通过显示软脑膜血管瘤病和异常静脉血管,实现对SWD的早期无创诊断。