成人DWI脑皮质“花边征”1例并文献复习

doi:10.3969/j.issn.1004-583X.2024.09.010

摘要/Abstract

摘要：

目的探讨核磁扩散加权成像 (diffusion-weighted imaging, DWI) 表现为脑皮质“花边征”的临床特点。方法分析1例脑皮质“花边征”患者的临床资料、相关检查资料、影像学资料及文献复习。结果患者主因双手不自主抓物伴行走不稳10 d,加重2 d入院,颅脑影像学检查示脑皮质“花边征”:大脑皮质在T1加权像、核磁扩散加权成像及液体衰减反转回复序列上呈沿脑沟回走行的高信号,以核磁扩散加权成像序列信号增高最为明显,反映了病变大脑皮质的细胞毒性水肿。给予患者对症治疗。患者症状逐渐加重,约半年后去世。结论脑皮质“花边征” 是脑皮质层状坏死典型影像学改变,见于血管性,感染性,代谢性,中毒性等多种神经系统疾病。深入了解脑皮质“花边征”的发病机制及病因,有利于临床诊断及鉴别诊断。

关键词: 大脑皮质, 花边征, 脑皮质层状坏死, 磁共振成像, 鉴别诊断

Abstract:

Objective To investigate the clinical characteristics of cortical “ribbon sign” on diffusion-weighted imaging (DWI). Methods The clinical data, relevant examination data, and imaging data of a case of cortical “ribbon sign” were analyzed, and relevant literatures were reviewed. Results The patient was admitted to the hospital due to involuntary grasping of objects with a walking instability for 10 days, and aggravated for 2 days. Brain imaging examination showed cortical “ribbon sign”, manifesting as a high signal intensity along the cerebral sulcus on T1-weighted imaging, DWI and fluid-attenuated inversion recovery sequence. The increase in signal intensity was pronounced on DWI sequence, reflecting the cytotoxic edema of the cerebral cortex. Symptomatic treatment was performed. The patient's symptoms gradually worsened and died about half a year later. Conclusion Cortical ribbon sign is a typical imaging change of laminar necrosis of the cerebral cortex, usually observed in vascular, infectious, metabolic, and toxic nerve system diseases. A deep mining of the pathogenesis and causes of cortical ribbon sign favors the clinical diagnosis and differentiation diagnosis.

Key words: cerebral cortex, ribbon sign, cortical laminar necrosis, magnetic resonance imaging, differentiation diagnosis

中图分类号:

R445.2

张迎秋, 张津, 葛世豪, 陈俊敏. 成人DWI脑皮质“花边征”1例并文献复习[J]. 临床荟萃, 2024, 39(9): 821-824.

Zhang Yingqiu, Zhang Jin, Ge Shihao, Chen Junmin. Cortical “ribbon sign” on DWI in adults: A case report and literature review[J]. Clinical Focus, 2024, 39(9): 821-824.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2024.09.010

https://huicui.hebmu.edu.cn/CN/Y2024/V39/I9/821

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