Krankenanstalt Rudolfstiftung, Messerli Institute, Postfach 20, 1180 Vienna, Austria.
J Neurol Sci. 2019 Sep 15;404:29-35. doi: 10.1016/j.jns.2019.07.013. Epub 2019 Jul 10.
Among the organs/tissues affected in mitochondrial disorders (MIDs), the brain is the second most frequently affected. Cerebral imaging may correlate with clinical findings but not necessarily. This review summarises and discusses current knowledge and recent advances concerning cerebral abnormalities on imaging in adult MIDs (≥18y).
Systematic literature review.
The most common cerebral abnormalities in imaging in adult MIDs are, as in pediatric MIDs, white matter lesions, grey matter lesions, atrophy, optic atrophy, stroke-like lesions, calcifications, and ischemic stroke. Cerebral lesions may remain stable over years but some may undergo dynamic changes within shorter or longer period of times. Typical dynamic lesions are stroke-like lesions and grey matter lesions in the sense of progression or regression. Since cerebral lesions on imaging may or may not go along with clinical manifestations, it is crucial to screen all MID patients for cerebral involvement, which can be effectively accomplished by application of the MRI.
Cerebral imaging is of paramount importance for diagnosing and monitoring cerebral involvement in MIDs. Cerebral imaging in MIDs contributes to the understanding of the pathogenesis of cerebral involvement in MIDs.
在受影响的器官/组织中(线粒体疾病(MIDs),大脑是第二常见的受影响的器官。脑部影像学检查可能与临床发现相关,但不一定相关。本文总结并讨论了目前关于成人 MIDs(≥18 岁)脑部影像学异常的知识和最新进展。
系统文献回顾。
成人 MIDs 影像学最常见的脑部异常与儿科 MIDs 一样,包括白质病变、灰质病变、萎缩、视神经萎缩、类似中风的病变、钙化和缺血性中风。脑部病变可能多年保持稳定,但有些病变可能在较短或较长时间内发生动态变化。典型的动态病变是类似中风的病变和灰质病变的进展或消退。由于脑部影像学上的病变可能与临床表现不一致,因此对所有 MID 患者进行脑部受累筛查至关重要,MRI 的应用可以有效地完成这一筛查。
脑部影像学对诊断和监测 MIDs 中的脑部受累具有至关重要的意义。MIDs 中的脑部影像学检查有助于理解 MIDs 中脑部受累的发病机制。