继发于上神经核团病变的肥大性下橄榄核变性的影像学表现-附6例报告并复习文献及探讨病理机制

发布时间：2018-07-24 17:14

【摘要】：目的探讨肥大性下橄榄核变性(hypertrophic olivary degeneration,HOD)影像学征象与病理学机制的关系,旨在提高对本病认识和诊断水平。方法回顾性分析6例经临床及影像证实的肥大性下橄榄核变性的临床特征及MRI表现,并对HOD的临床特征、影像学特征与病理学机制复习文献进行分析。结果 1例原发病变位于一侧脑桥被盖束及对侧小脑齿状核/小脑上脚,引起同侧HOD;2例原发病变位于一侧桥脑被盖束,引起同侧HOD;2例原发病变累及双侧桥脑被盖束,其中1例引起双侧HOD,1例引起单侧HOD;1例原发病变累及一侧小脑上脚,引起双侧HOD。6例HOD的MRI均表现为延髓腹外侧局限性体积增大,T2WI及FLAIR均呈高、稍高信号;T1WI等信号者5例,稍高信号者1例。结论肥大性下橄榄核变性有较为特征性的临床表现、发病部位及影像学表现,结合其上游原发病变可作出诊断。
[Abstract]:Objective to investigate the relationship between imaging signs and pathological mechanism of hypertrophic olivary degeneration (hypertrophic olivary degenerationhod) in order to improve the understanding and diagnosis of the disease. Methods the clinical features and MRI findings of 6 cases of hypertrophic hypoolivary degeneration confirmed by clinical and imaging were retrospectively analyzed. The clinical features, imaging features and pathological mechanism of HOD were reviewed. Results one case was located in the unilateral pons tegmental tract and the contralateral dentate nucleus / superior cerebellar foot, 2 cases of the ipsilateral HODN were located in the unilateral pons tegmental tract, 2 cases caused ipsilateral HOD2 involving bilateral pontine tegmental tract. Among them, one case caused bilateral hypoderma, one case caused unilateral hypoderma, and one case caused primary lesion involving unilateral superior cerebellar foot. The MRI of bilateral HOD.6 cases showed that the local volume of ventrolateral medulla was increased in both T _ 2WI and FLAIR, and the signal intensity was slightly high on T _ 1WI in 5 cases. The signal intensity was slightly higher in 1 case. Conclusion hypertrophic olivary degeneration is characterized by its clinical manifestations, location and imaging findings, and can be diagnosed by combining with its upstream primary changes.
【作者单位】：中山大学附属第一医院放射科;中山大学附属第一医院神经外科;
【分类号】：R445.2;R741

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