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低血糖性脑病的影像学表现:一例高b值扩散加权成像分析的病例报告

The radiological findings of hypoglycemic encephalopathy: A case report with high b value DWI analysis.

作者信息

Ren Shan, Chen Zhigang, Liu Ming, Wang Zhiqun

机构信息

Department of Neurology Department of Radiology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China.

出版信息

Medicine (Baltimore). 2017 Oct;96(43):e8425. doi: 10.1097/MD.0000000000008425.

Abstract

RATIONALE

Hypoglycemic encephalopathy is a metabolic encephalopathy. Clinical risk is mixed with acute cerebrovascular disease, so it is critical to identify and make the correct diagnosis of the disease as early as possible.

PATIENT CONCERNS

Here, we report a case of a 51-year-old male patient with hypoglycemic encephalopathy, who presented confusion and unconsciousness for 1 day.

DIAGNOSES

In addition to blood-related indicators and medical histories, magnetic resonance imaging (MRI), especially diffusion-weighted imaging (DWI), can be valuable to the diagnosis of hypoglycemic encephalopathy, which showed diffuse high-signal intensity in the cerebral cortex, and also the hippocampus, head of the caudate nucleus, the lentiform nucleus, and corpus callosum.

INTERVENTIONS

Intravenous glucose injection and drip was performed repeatedly. The blood glucose levels were gradually corrected, and the resulting blood glucose was 6.5 mmol/L.

OUTCOMES

The prognosis depends on the degree of hypoglycemia, duration, and condition of the organism. Due to the long duration of hypoglycemia, unfortunately, the patient died.

LESSONS

It is critical to diagnose hypoglycemic encephalopathy as early as possible. MRI reveals diffuse abnormal intensity in the cortex and basal ganglia region. DWI using high b values provides important information for diagnosis.

摘要

理论依据

低血糖性脑病是一种代谢性脑病。临床风险与急性脑血管疾病相混杂,因此尽早识别并正确诊断该疾病至关重要。

患者情况

在此,我们报告一例51岁男性低血糖性脑病患者,该患者出现意识模糊和昏迷达1天。

诊断

除了血液相关指标和病史外,磁共振成像(MRI),尤其是弥散加权成像(DWI),对低血糖性脑病的诊断可能有价值,其显示大脑皮质以及海马、尾状核头部、豆状核和胼胝体呈弥漫性高信号强度。

干预措施

反复进行静脉注射和滴注葡萄糖。血糖水平逐渐得到纠正,最终血糖为6.5 mmol/L。

结果

预后取决于低血糖的程度、持续时间和机体状况。不幸的是,由于低血糖持续时间较长,该患者死亡。

经验教训

尽早诊断低血糖性脑病至关重要。MRI显示皮质和基底节区弥漫性异常信号强度。使用高b值的DWI为诊断提供重要信息。

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