【摘要】 目的探讨延髓背外侧综合征(lateral medullary syndrome,LMS)的MRI表现及其临床应用价值。资料与方法回顾临床确诊的15例LMS患者的影像资料。均行MRI检查,常规行MRI、扩散加权成像(DWI)及三维时间飞跃法(3D-TOF)血管成像,分析病灶累及部位和各序列的MRI特征。结果 MRI示15例有延髓梗死灶,其中5例病变局限于延髓,9例病变同时累及桥脑、小脑或枕叶,另1例同时累及小脑。梗死灶以延髓背外侧长T1、长T2信号为主要特征。15例在DWI上呈高信号,治疗后随访10例呈等信号,5例呈局限性低信号;15例在T2-液体衰减反转恢复序列(FLAIR)上均呈高信号。磁共振血管造影(MRA)示病变侧椎动脉及分支狭窄、闭塞等。结论 LMS以单侧延髓损害为特征性表现,亦可累及同侧相邻部位。T2-FLAIR、DWI和MRA对LMS的诊断及治疗随访有重要价值,MRI可作为LMS的首选影像诊断手段。更多还原

【Abstract】 Objective To study the MRI features and its clinical significance of Lateral Medullary Syndrome (LMS). Materials and Methods 15 patients with clinically proved LMS underwent MR imaging,the image features were retrospectively analyzed.The MR sequences included conventional MR,DWI,and 3D-TOF MRA. Results 15 patients showed a lateral medullary infarction corresponding to clinical defects on MRI images,5 patients with the infarction involving the medulla only,and 9 patients with the infarct involving the medulla and pons or the ipsilateral cerebella or occipital lobe,1 patient with the infarction involving the ipsilateral cerebella besides medulla.The MRI images of all cases were indicated that the lateral medullary had long T1 and long T2 signal.Hyperintensity signal was found on DWI images in 15 cases,After the treatment,isointensity signal was found on DWI images in 10 cases,and hypointensity signal in 5 cases,all of the cases had hyperintensity signal on T2-FLAIR images. Occlusions or stenoses of the ipsilateral vertebral arteries were shown in the 15 patients on MRA. Conclusion Unilateral medullary involvement is the conspicuous characteristic of the LMS,and LMS can also invade ipsilateral surrounding brain tissue.T2-FLAIR,DWI and MRA have important value in the diagnosis and follow-up during treatment,MRI is suggested to be the first choice in the diagnosis of LMS.更多还原