不同亚型多系统萎缩患者磁共振成像特征分析

摘要

Objective To analyze the magnetic resonance imaging (MRI) features of different subtypes of multiple system atrophy (MSA) and to investigate its significance.Methods A total of 32 patients with MSA were retrospectively analyzed,during whom 15 patients underwent magnetic resonance imaging (MRI) in our hospital.Three aspects o f activities of daily living (ADL) were used to assess the progression of disease.Results During 13 patients with MSA-C,2 cases showed no "cross sign" (stage 0) within 9 months,1 case showed stage Ⅰ,2 cases showed stage Ⅱ,4 cases showed stage Ⅲ,3 cases showed stage Ⅳ and 1 case showed stage Ⅴ,and all the 13 patients with MSA-C showed stage 0 "putaminal slit" ; 2 patients with MSA-P showed stage 0 "cross sign" and " putaminal slit".During 13 patients with MSA-C,5cases of cross sign didn't reach stage Ⅲ,walking instability in 3 cases,including 1 cases of auxiliary walking state; 4 cases in stage Ⅲ were walking instability,among which 2 patients needed assisted walking; 3 cases in stage Ⅳ,among which 1 case needed assisted walking,2 cases needed wheelchairs; 1 case in stage Ⅴ was in a wheelchair.In 2 patients with MSA-P,1 patients could walk independently and 1 case needed auxiliary walking.Conclusions The combination of clinical manifestations and MRI examination contribute to the diagnosis of MSA and its subtypes.The stages of MRI may have a relationship with the progression of clinical symptoms.%目的 分析多系统萎缩(MSA)不同亚型的磁共振成像(MRI)特征,并探讨其意义.方法 选择MSA患者32例,其中15例行MRI,并用日常生活活动能力(ADL)的3个重要事件对疾病进展进行评估.结果 13例小脑萎缩型(MSA-C)患者中,MRI检查脑桥十字征0期2例、Ⅰ期1例、Ⅱ期2例、Ⅲ期4例、Ⅳ期3例、Ⅴ期1例,壳核裂隙征分期均为0期；2例帕金森型(MSA-P)患者脑桥十字征和壳核裂隙征分期均为0期.13例MSA-C患者中,5例脑桥十字征未达Ⅲ期者,行走不稳3例,其中1例为辅助行走状态；4例Ⅲ期者均行走不稳,其中2例需辅助行走；3例Ⅳ期者中,辅助行走1例,依靠轮椅2例；1例Ⅴ期者依靠轮椅.2例MSA-P患者中,可独立行走1例,辅助行走1例.结论 头部MRI脑桥十字征、壳核裂隙征有助于MSA亚型的鉴别,且影像学特征分期与病情进展程度有一定关系.