【摘要】 目的分析多系统萎缩(MSA)患者的临床表现与MRI特征,为临床诊断提供依据。方法回顾性分析21例MSA患者的临床资料,包括首发症状、临床特点及头部MRI特征。结果 MSA-P亚型7例,MSA-C亚型14例。MSA-C以行走不稳定为主要首发表现(92.9%),头部MRI主要表现为脑干(71.4%)、小脑中脚(71.4%)、小脑蚓部或半球萎缩(85.7%),第四脑室(85.7%)、桥延池(78.6%)扩大,T2WI脑桥(十字征)(71.4%)及小脑中脚(50%)对称性高信号等。MSA-P以行动迟缓为主要首发表现(85.7%),头部MRI主要表现为以壳核为主的基底节区萎缩(71.4%),T2WI壳核后外部低信号(71.4%)及外侧缘高信号(57.1%)。结论 MSA是一组神经系统多部位变性综合征,MRI对MSA的早期诊断和亚型判断有重要的意义。更多还原

【Abstract】 Objective To analyze the clinical and MRI features of the multiple system atrophy( MSA),in order to get more evidence for diagnosing this disease correctly. Methods Retrospectively analyzed 21 cases of MSA including the beginning symptom,clinical characteristic and brain MRI features. Results 7 cases were MSA-P subtype,and the other 14 cases were MSA-C subtype. Unstable walking as the main initial presentation was seen in 92. 9% of MSA-C subtype. It was shown that brain stem( 71. 4%),middle cerebellar peduncles( 71. 4%),cerebellar vermis or hemisphere( 85. 7%) were atrophic,the fourth ventricle( 85. 7%) and cistern( 78. 6%) were dilated,T 2 WI high intensity was in the pontocerebellar( Cross sign)( 71. 4%) and middle cerebellar peduncle regions( 50%) in MRI. Bradypraxia as the initial symptom was found in 85. 7% of MSA-P subtype. It was shown that putamen( 71. 4%) dominant basal ganglia were atrophic and T 2 WI high intensity was in the outer back( 71. 4%) and lateral margin( 57. 1%) of putamen in MRI. Conclusions MSA is a symptom of multiple areas degeneration of nervous system,MRI facilitates early diagnosis and subtype judgment of MSA.更多还原