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[人脑标本的死后磁共振成像与病理检查的比较研究]

[A comparative study of postmortem MR imaging and pathological examination of human brain specimens].

作者信息

Shiga T

机构信息

Department of Nuclear Medicine, Hokkaido University School of Medicine, Sapporo, Japan.

出版信息

Hokkaido Igaku Zasshi. 1998 Sep;73(5):497-504.

PMID:9846279
Abstract

This study was designed to assess the value of MRI of the postmortem brain specimens by comparing MRI findings with neuropathological findings. Postmortem MRI was performed in 17 consecutive formalin-fixed whole brains comprisig 3 with primary CNS neoplasm, 1 with metastatic brain tumor, 6 with cerebral vascular disease (CVD), 1 with degenerative disease, 1 with spongy state in thalamus, and 5 with no abnormality. Postmortem T2WI detected all neuropathological abnormalities but sparsely distributed tumor cells without edema. In one case of CNS neoplasm, the tumor lesions with little necrosis or edema showed isointensity to brain tissue, while others with large amounts of necrosis and edema showed high signal intensity on T2WI. In the cases of CVD, the major signal changes on T2WI were due to edema, necrosis, and damage of the organization as observed on neuropathological studies. There was one case in which both MRI and neuropathological examination showed an abnormality, which was pathologically unexplainable. In two cases, findings of postmortem MRI were more apparent than those of macroscopic examination. Postmortem MRI appeared different from premortem MRI in one of the rest three cases whereas the postmortem MRI correlated well with neuropathological findings. Progression of the disease immediately before death may have caused this difference. In conclusion, the correlations between MRI and neuropathological findings facilitate understanding the mechanisms responsible for MRI abnormalities. An increase in free water in edema, necrosis, and damage in brain tissue can explain an increased signal intensity on T2WI. Postmortem MRI may contribute to the effective pathological examination by pointing out subtle abnormalities before brain cutting.

摘要

本研究旨在通过比较MRI表现与神经病理学表现来评估死后脑标本的MRI价值。对17例连续的福尔马林固定全脑进行了死后MRI检查,其中3例患有原发性中枢神经系统肿瘤,1例患有脑转移瘤,6例患有脑血管疾病(CVD),1例患有退行性疾病,1例丘脑呈海绵状状态,5例无异常。死后T2WI检测到了所有神经病理学异常,但未检测到无水肿的稀疏分布肿瘤细胞。在1例中枢神经系统肿瘤中,坏死或水肿较少的肿瘤病变在T2WI上与脑组织呈等信号,而其他坏死和水肿较多的病变在T2WI上呈高信号。在CVD病例中,T2WI上的主要信号变化是由于神经病理学研究中观察到的水肿、坏死和组织损伤。有1例MRI和神经病理学检查均显示异常,但病理上无法解释。在2例中,死后MRI表现比大体检查更明显。在其余3例中的1例中,死后MRI与生前MRI不同,而死后MRI与神经病理学表现相关性良好。死亡前疾病的进展可能导致了这种差异。总之,MRI与神经病理学表现之间的相关性有助于理解MRI异常的机制。脑组织水肿、坏死和损伤中自由水的增加可以解释T2WI上信号强度的增加。死后MRI可能通过在脑切片前指出细微异常而有助于有效的病理检查。

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