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目的 利用MRI-磁敏感加权成像(SWI)和流动敏感交互式反转恢复(FAIR)技术探索急性百草枯(PQ)中毒的中枢神经系统毒性。资料与方法 36例急性PQ中毒患者及其年龄、性别、职业相匹配的对照组36名进入本实验,搜集必要临床资料,行MRIT1-液体衰减反转恢复(FLAIR)、快速恢复快速自旋回波(FRFSE)-T2WI、重度T2*加权成像(ESWAN)-SWI和FAIR检查。比较两组不同脑区相对脑血流量(rCBF)的差异及其与血毒物浓度的关系。结果 SWI未发现异常出血灶。中毒患者中脑及额叶的rCBF低于对照组,差异有统计学意义,下降绝对值与血毒物浓度呈弱相关。不同脑区的rCBF值有明显差异,海马区血供较丰富。结论 急性PQ中毒可能影响了某些脑区的微循环(比如中脑),从而造成特异性损害。
Objective To explore central nervous system toxicity of acute paraquat (PQ) poisoning using MRI-susceptibility weighted imaging (SWI) and flow-sensitive interactive reverse recovery (FAIR) MATERIALS AND METHODS Thirty - six patients with acute PQ intoxication and their age, sex and occupation matched control group were enrolled into this study. The necessary clinical data were collected and MRIT1 - FLAIR was restored. Fast spin echo (FRFSE) -T2WI, severe T2 * weighted imaging (ESWAN) -SWI and FAIR examinations. The differences of relative cerebral blood flow (rCBF) in different brain regions and their relationship with blood levels were compared between the two groups. Results SWI found no abnormal hemorrhage. The rCBF of midbrain and frontal lobe of poisoning patients was lower than that of the control group, and the difference was statistically significant. The absolute value of decline was weakly correlated with the blood poisoning concentration. The rCBF values in different brain regions are significantly different, hippocampus blood supply is more abundant. Conclusion Acute PQ poisoning may affect the microcirculation (such as the midbrain) of some brain regions, causing specific damage.