本文报告46例BD,60岁以上男性多见,多有长期高血压和/或反复脑卒中史。临床以慢性进行性智能衰退为突出表现,中晚期呈痴呆,多伴有与智能障碍同时或提前出现的局灶神经体征。脑CT显示:脑室周围及半卵圆中心白质大致对称的弥漫性低密度改变,基底节区、丘脑等处并存多发腔隙性梗塞灶,脑室对称性扩大和不同程度的髓质性脑萎缩。BD的生前诊断应强调临床-CT(或MRI)-病理相统一的概念。 This article reports 46 cases of BD, more common in men over the age of 60, more than long-term hypertension and / or repeated stroke history. Clinically, chronic progressive intelligent decline is a prominent manifestation of advanced dementia, and more accompanied with mental retardation at the same time or early appearance of focal neurological signs. Brain CT showed diffuse low-density changes of the white matter around the periventricular and semi-oval centers, with multiple lacunar infarcts coexisting in the basal ganglia and thalamus, with enlarged ventricular symmetry and varying degrees of medullary atrophy. Prenatal diagnosis of BD should emphasize the concept of clinical-CT (or MRI) -based pathology.