Department of Diagnostic Imaging, Institute of Mother and Child, ul. Kasprzaka 17a, 01-211 Warsaw, Poland.
Eur J Radiol. 2013 May;82(5):837-49. doi: 10.1016/j.ejrad.2012.12.006. Epub 2013 Jan 10.
The term "basal ganglia" refers to caudate and lentiform nuclei, the latter composed of putamen and globus pallidus, substantia nigra and subthalamic nuclei and these deep gray matter structures belong to the extrapyramidal system. Many diseases may present as basal ganglia abnormalities. Magnetic resonance imaging (MRI) and computed tomography (CT) - to a lesser degree - allow for detection of basal ganglia injury. In many cases, MRI alone does not usually allow to establish diagnosis but together with the knowledge of age and circumstances of onset and clinical course of the disease is a powerful tool of differential diagnosis. The lesions may be unilateral: in Rassmussen encephalitis, diabetes with hemichorea/hemiballism and infarction or - more frequently - bilateral in many pathologic conditions. Restricted diffusion is attributable to infarction, acute hypoxic-ischemic injury, hypoglycemia, Leigh disease, encephalitis and CJD. Contrast enhancement may be seen in cases of infarction and encephalitis. T1-hyperintensity of the lesions is uncommon and may be observed unilaterally in case of hemichorea/hemiballism and bilaterally in acute asphyxia in term newborns, in hypoglycemia, NF1, Fahr disease and manganese intoxication. Decreased signal intensity on GRE/T2*-weighted images and/or SWI indicating iron, calcium or hemosiderin depositions is observed in panthotenate kinase-associated neurodegeneration, Parkinson variant of multiple system atrophy, Fahr disease (and other calcifications) as well as with the advancing age. There are a few papers in the literature reviewing basal ganglia lesions. The authors present a more detailed review with rich iconography from the own archive.
术语“基底节”是指尾状核和豆状核，后者由壳核和苍白球、黑质和丘脑底核组成，这些深部灰质结构属于锥体外系。许多疾病可表现为基底节异常。磁共振成像（MRI）和计算机断层扫描（CT）——程度较低——允许检测基底节损伤。在许多情况下，MRI 通常不足以单独做出诊断，但结合年龄、发病情况和疾病的临床过程，是鉴别诊断的有力工具。病变可能是单侧的：在 Rasmussen 脑炎、糖尿病伴偏侧舞动/偏侧投掷症和梗死，或更常见的是在许多病理情况下双侧的。弥散受限归因于梗死、急性缺氧缺血性损伤、低血糖、 Leigh 病、脑炎和 Creutzfeldt-Jakob 病。对比增强可见于梗死和脑炎病例。病变的 T1 高信号不常见，单侧偏侧舞动/偏侧投掷症可能观察到，双侧急性窒息的足月新生儿、低血糖、NF1、Fahr 病和锰中毒也可能观察到。GRE/T2*-加权图像和/或 SWI 上的信号强度降低，提示铁、钙或含铁血黄素沉积，见于泛酸激酶相关神经退行性变、多系统萎缩的帕金森变异型、Fahr 病（和其他钙化）以及随年龄增长。文献中有几篇关于基底节病变的综述。作者从自己的存档中提供了更详细的综述，并附有丰富的图像。
