Department of Clinical Pharmacy, Affiliated Hospital of Yangzhou University, Yangzhou, China.
Department of Radiology, Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China.
Sci Rep. 2023 Oct 28;13(1):18516. doi: 10.1038/s41598-023-45431-6.
We aimed to investigate the clinico-radiologic features of acute Marchiafava-Bignami disease (MBD) and its evolutionary process after effective treatment through subgroup comparison. The clinical and MRI data of 23 patients with acute MBD were retrospectively analyzed and divided into type A (12 cases, with entire callosal involvement) and type B (11 cases, with focal callosal involvement). The clinical assessments and MRI findings (before and after treatment) were compared between the two subtypes. Compared with type B, type A had lower MoCA (Montreal Cognitive Assessment) scores at admission (16.50 ± 1.73 vs 18.27 ± 1.68, P = 0.021) and were more common with extracallosal involvement (66.67% vs 18.18%, P = 0.036) and longer illness duration (18.3 ± 2.1 days vs 15.6 ± 2.4 days, P = 0.012). During the treatment, the residual lesion in the splenium was more common in type A (58.33% vs 9.09%, P = 0.027). After treatment, the MoCa scores of both subtypes gradually increased (P < 0.001), and the callosal and extracallasal lesions disappeared completely. Clinico-radiologic typing of acute MBD is related to the severity of early symptoms, but not to the prognosis. Complete clinico-radiologic recovery is possible for both subtypes with combined treatment. The clinico-radiologic reversibility is helpful for accurate diagnosis and therapeutic evaluation.
我们旨在通过亚组比较，探讨急性 Marchiafava-Bignami 病（MBD）的临床-放射学特征及其有效治疗后的演变过程。回顾性分析了 23 例急性 MBD 患者的临床和 MRI 数据，并分为 A 型（12 例，胼胝体完全受累）和 B 型（11 例，胼胝体局灶受累）。比较了两种亚型之间的临床评估和 MRI 结果（治疗前后）。与 B 型相比，A 型患者在入院时的 MoCA（蒙特利尔认知评估）评分较低（16.50±1.73 与 18.27±1.68，P=0.021），更常见于胼胝体以外的受累（66.67%与 18.18%，P=0.036），病程更长（18.3±2.1 天与 15.6±2.4 天，P=0.012）。在治疗过程中，A 型患者的胼胝体压部残留病变更为常见（58.33%与 9.09%，P=0.027）。治疗后，两种亚型的 MoCa 评分均逐渐升高（P<0.001），胼胝体和胼胝体外病变完全消失。急性 MBD 的临床-放射学分型与早期症状的严重程度有关，但与预后无关。联合治疗后，两种亚型均有可能完全临床-放射学恢复。临床-放射学的可逆性有助于准确诊断和治疗评估。
