Finkenstaedt M, Szudra A, Zerr I, Poser S, Hise J H, Stoebner J M, Weber T
Department of Radiology, Scott and White Clinic and Memorial Hospital, Sherwood, Temple, TX 76508, USA.
Radiology. 1996 Jun;199(3):793-8. doi: 10.1148/radiology.199.3.8638007.
To describe the magnetic resonance (MR) imaging appearance of Creutzfeldt-Jakob disease (CJD).
MR images obtained in 29 patients who died of CJD (aged 53-77 years at death) were retrospectively reviewed by three neuroradiologists blinded to the diagnosis.
Moderate to marked bilateral, symmetrically increased signal intensity was demonstrated in the putamen and caudate nucleus on T2- and proton-density-weighted MR images in 23 patients (79%). In six patients (21%), images showed no major signal intensity abnormalities. T1-weighted images revealed no signal intensity abnormalities and no contrast material enhancement. The degree of atrophy in the cortex and basal ganglia corresponded to the time between onset of symptoms and MR imaging. All patients with a disease duration of longer than 4 months had substantial volume loss.
Although approximately 20% of the patients did not have MR imaging abnormalities, MR imaging did show signal intensity alterations due to gliosis and spongiform changes early in the course of CJD in the remaining 80%. The demonstration of bilateral areas of increased signal intensity that predominantly affected the caudate nuclei and the putamina on long-repetition-time MR images in an elderly patient with rapidly progressive dementia represents a specific finding and clearly should suggest the diagnosis of CJD.
描述克雅氏病（CJD）的磁共振（MR）成像表现。
对29例死于CJD的患者（死亡时年龄53 - 77岁）的MR图像进行回顾性分析，由三位对诊断不知情的神经放射科医生进行阅片。
23例患者（79%）在T2加权和质子密度加权MR图像上，壳核和尾状核显示中度至明显的双侧对称性信号强度增加。6例患者（21%）图像未显示主要信号强度异常。T1加权图像未显示信号强度异常及对比剂增强。皮质和基底节的萎缩程度与症状出现至MR成像的时间相关。所有病程超过4个月的患者均有明显的体积缩小。
虽然约20%的患者MR成像无异常，但在其余80%的CJD患者病程早期，MR成像确实显示了由于胶质增生和海绵状改变引起的信号强度改变。在患有快速进展性痴呆的老年患者中，长重复时间MR图像上主要累及尾状核和壳核的双侧信号强度增加区域的显示是一个特异性表现，显然应提示CJD的诊断。
