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目的 总结海洛因海绵状白质脑病的CT及MRI特征。方法 分析 5例海洛因海绵状白质脑病的临床特点、影像表现及 1例病理所见 ,总结其CT和MRI的诊断要点。结果 海洛因海绵状白质脑病的CT和MRI特征为 :(1)病变广泛累及小脑、大脑白质及脑干、内囊后肢 ,多以小脑损害为重 ,其中以小脑中线两侧对称性边界清楚的类圆形蝴蝶样病灶为特征 ;(2 )病灶双侧对称 ,边界清楚 ;(3)CT示病灶为低密度。MRI示病灶为T1WI低信号以及T2 WI高信号影 ;(4 )增强病灶无强化。主要的病理改变为脑白质的空泡样变性。结论 海洛因海绵状白质脑病的CT和MR表现有特征性改变 ,有海洛因烫吸史者 ,一旦出现小脑受损的表现 ,应及早行头部影像学检查明确诊断。
Objective To summarize CT and MRI features of heroin spongiform encephalopathy. Methods The clinical features, imaging findings and pathological findings of 5 cases of heroin cavernous leukoencephalopathy were analyzed. The diagnostic criteria of CT and MRI were summarized. Results CT and MRI features of heroin cavernous leukoencephalopathy were as follows: (1) Lesions were widely involved in the cerebellum, white matter and brainstem of the brain, hindlimbs of the internal capsule, mostly cerebellar damage, of which the border Circular butterfly-like lesions are characterized; (2) Bilateral symmetry, clear boundary; (3) CT showed low density lesions. MRI lesions showed low T1WI signal and T2 WI high signal; (4) no enhancement of enhanced lesions. The main pathological changes of vacuolar degeneration of the white matter. Conclusions CT and MR manifestations of heroin cavernous leukoencephalopathy have characteristic changes. Those with history of heroin abuse have a clear diagnosis of cerebellar impaired.