13例延髓梗死患者的影像学表现及临床特征分析

摘要

目的 分析13例延髓梗死(MI)患者的影像学表现及临床特征.方法 回顾性分析2014年10月-2016年10月徐州市丰县人民医院收治的13例MI患者的临床资料.所有患者经磁共振成像(MRI)检查确诊,同时7例患者行磁共振血管造影(MRA)检查,5例患者行CT血管造影(CTA)检查,1例患者行MRA及CTA检查.结果 13例MI患者中4例为延髓内侧梗死(MMI),9例为延髓外侧梗死(LMI).9例LMI患者中6例表现为Wallenberg综合征,2例表现为Avellis综合征,1例表现为Babinski-Nageotte综合征.4例MMI患者中,1例表现为经典Dejerine综合征,1例表现为Jackson综合征,1例表现为单纯轻偏瘫,1例表现为双侧MMI综合征.LMI、MMI患者中由椎动脉和/或基底动脉粥样硬化所致者分别占7/9、3/4.13倒患者中2例因呼吸循环衰竭而自动出院,其余11例经治疗后症状明显改善,但均遗留不同程度肢体运动或感觉障碍、吞咽困难及构音障碍.结论 MI可分为MMI和LMI,其临床表现与梗死部位相关,动脉粥样硬化是导致MI的主要原因;MRI对MI的诊断价值较高.%Objective To analyze the imaging findings and clinical features of 13 patients with medullary infarction.Methods From October 2014 to October 2016,a total of 13 patients with medullary infarction were selected in the people's Hospital of Feng Cunty,Xuzhou,and their clinical data was retrospectively analyzed.All of the 13 patients were diagnosed by MRI,meanwhile 7 patients received MRA,5 patients received CTA,1 patient received MRA and CTA.Results Of the 13 patlents,4 patients were medial medullary infarction (MMI),9 patients were lateral medullary infarction (LMI).Of the 9 patients with LMI,6 patients performed as Wallenberg syndrome,2 patients performed as Avellis syndrome,1 patient performed as Babinski-Nageotte syndrome.Of the 4 patients with MMI,1 patient performed as classic Dejerine syndrome,1 patient performed as Jackson syndrome,1 patient performed as isolated mild hemiplegia,1 patient performed as bilateral MMI syndrome.Of the 9 patients with LMI,7 patients were caused by vertebral artery and/or basilar artery atherosclerosis;of the 4 patients with MMI,3 patients were caused by vertebral artery and/or basilar artery atherosclerosis.Of the 13 patients,2 patients discharged due to respiratory and circulatory failure without cure,other 11 patients'symptoms significantly relived after treatment,with varying degrees of limb movement or feeling disturbance,dysphagia and dysarthria.Conclusion Medullary infarction can be divided into LMI and MMI,the clinical features are associated with infarction location,and atherosclerosis is the leading cause;MRI has relative high diagnostic value on medullary infarction.