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脑白质表观弥散系数受限：超越急性脑区域性缺血。

Apparent diffusion coefficient restriction in the white matter: going beyond acute brain territorial ischemia.

机构信息

University of Padua, Neuroradiological Unit, Padova, Italy,

出版信息

Insights Imaging. 2012 Apr;3(2):155-64. doi: 10.1007/s13244-011-0114-3. Epub 2011 Dec 20.

DOI:10.1007/s13244-011-0114-3
PMID:22696041
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3314735/
Abstract

BACKGROUND

Reduction of apparent diffusion coefficient (ADC) values in white matter is not always ischaemic in nature.

METHODS

We retrospectively analysed our MRI records featuring reduced ADC values in the centrum semiovale without grey matter involvement or significant vasogenic oedema.

RESULTS

Several conditions showed the aforementioned MR findings: moose-horn lesions on coronal images in X-linked Charcot-Marie-Tooth disease; small fronto-parietal lesions in Menkes disease; marked signal abnormalities in the myelinised regions in the acute neonatal form of maple syrup urine disease; strip-like involvement of the corpus callosum in glutaric aciduria type 1; persistent periventricular parieto-occipital abnormalities in phenylketonuria; diffuse signal abnormalities with necrotic evolution in global cerebral anoxia or after heroin vapour inhalation; almost completely reversible symmetric fronto-parietal lesions in methotrexate neurotoxicity; chain-like lesions in watershed ischaemia; splenium involvement that normalises in reversible splenial lesions or leads to gliosis in diffuse axonal injury.

CONCLUSION

Neuroradiologists must be familiar with these features, thereby preventing misdiagnosis and inappropriate management.

摘要

背景

脑白质表观扩散系数（ADC）值降低并不总是缺血性的。

方法

我们回顾性分析了磁共振成像（MRI）记录，这些记录显示脑半卵圆中心 ADC 值降低，无灰质受累或明显的血管源性水肿。

结果

多种情况下可出现上述 MRI 表现：X 连锁遗传性运动感觉神经病的额顶病变呈“鹿茸状”；Menkes 病的小额顶病变；枫糖尿症新生儿期髓鞘化区域明显信号异常；1 型戊二酸血症的胼胝体条状受累；苯丙酮尿症持续的脑室周围顶枕部异常；全脑缺氧或海洛因蒸气吸入后弥漫性信号异常伴坏死演变；甲氨蝶呤神经毒性几乎完全可逆对称的额顶病变；分水岭梗死的线状病变；可逆性胼胝体病变的分水岭受累或导致弥漫性轴索损伤的神经胶质增生。

结论

神经放射科医生必须熟悉这些特征，从而避免误诊和不适当的治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1ff/3314735/070c9668f58c/13244_2011_114_Fig12_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1ff/3314735/05974cbd4a1e/13244_2011_114_Fig11_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1ff/3314735/070c9668f58c/13244_2011_114_Fig12_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1ff/3314735/1b1595dd0ebf/13244_2011_114_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1ff/3314735/a1d73f8999c9/13244_2011_114_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1ff/3314735/1d0cc2a0b17b/13244_2011_114_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1ff/3314735/9cdbb2fff6ee/13244_2011_114_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1ff/3314735/57b059025459/13244_2011_114_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1ff/3314735/aae47764315b/13244_2011_114_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1ff/3314735/a7c456e095c5/13244_2011_114_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1ff/3314735/beee6816b6ee/13244_2011_114_Fig8_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1ff/3314735/1f7a316e055c/13244_2011_114_Fig9_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1ff/3314735/cfa38f5c60d3/13244_2011_114_Fig10_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1ff/3314735/05974cbd4a1e/13244_2011_114_Fig11_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1ff/3314735/070c9668f58c/13244_2011_114_Fig12_HTML.jpg

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