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目的探讨多系统萎缩(MSA)的临床、磁共振成像(MRI)特征及MRI对临床诊断的意义。方法回顾性分析32例MSA患者的临床及MRI资料,并探讨MRI特征与临床表现的关系。结果MSA的临床与MRI表现复杂,MSA-c小脑体征突出,MRI表现为脑桥、小脑中脚、蚓部萎缩,T2WI出现脑桥、小脑中脚高信号,并与临床小脑损害特征具有较高的一致性(P<0.05);MSA-p帕金森样症状明显,MRI改变多位于基底节核团,表现为壳核萎缩,T2WI壳核背外部低信号、壳核外侧缘高信号,后者与临床帕金森样症状无关联性(P>0.05)。结论综合分析临床资料与MRI信息有助于提高MSA各亚型诊断的准确性。
Objective To investigate the clinical and magnetic resonance imaging (MRI) features of multiple system atrophy (MSA) and the significance of MRI in clinical diagnosis. Methods The clinical and MRI data of 32 patients with MSA were retrospectively analyzed. The relationship between MRI features and clinical manifestations was also discussed. Results The manifestations of MSA were complicated with clinical and MRI manifestations. MSA-c cerebellar signs were prominent. MRI showed pyloric, middle cerebellar and vermicular atrophy. T2WI showed high signal in the pons and middle cerebellum, which was consistent with clinical features of cerebellar lesions (P <0.05). The symptoms of Parkinson’s disease in MSA-p were obvious. The changes of MRI were mostly found in the basal ganglia nucleus. The lesions showed atrophy of the nucleus, low signal of the hypocarpal nucleus of T2WI and high signal of the lateral margin of putamen, There was no correlation between Parkinson’s symptoms (P> 0.05). Conclusion The comprehensive analysis of clinical data and MRI information can help to improve the diagnostic accuracy of each subtype of MSA.