文章摘要
姚晴宇许著一孙杨马涛徐德恩.多系统萎缩的早期综合诊断[J].,2012,12(26):5117-5119
多系统萎缩的早期综合诊断
Early Comprehensive Diagnosis in Multiple System Atrophy
  
DOI:
中文关键词: 多系统萎缩  磁共振成像  Shy-Drager综合征  橄榄体脑桥小脑萎缩  黑质纹状体变性
英文关键词: MSA  MRI  Shy-Drager syndrome  Olivopontocerebellar atrophy  Striatonigral degeneration
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作者单位
姚晴宇许著一孙杨马涛徐德恩 南京医科大学附属无锡市第二人民医院神经内科 
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中文摘要:
      目的:探讨多系统萎缩(multiple system atrophy,MSA)患者的临床表现及神经影像学新特征(脑桥“十字征”和“壳核裂隙征”) 在MSA早期诊断中的临床意义。方法:回顾性分析21 例临床诊断为多系统萎缩(MSA)患者的临床表现和头部MRI资料。结 果:21例MSA患者中,Shy-Drager综合征(MSA-A)9例,早期临床表现为体位性低血压,泌尿生殖功能障碍,头部MRI检查脑桥 “壳核裂隙征”和“十字征”为Ⅰ期;橄榄体脑桥小脑萎缩(MSA-C)5 例,3 例发病后1 年头部MRI脑桥“十字征”达Ⅱ期;“壳核裂隙 征”为Ⅰ期,2例发病后3年头部MRI脑桥“十字征”达Ⅳ期。黑质纹状体变性(MSA-P)7例:早期临床均有运动迟缓、震颤等表现, 3例发病后1年脑桥“十字征”Ⅰ期,“壳核裂隙征”Ⅲ期;3 例发病后2 年脑桥“十字征”Ⅰ期,“壳核裂隙征”Ⅰ期;另1 例发病后9 月脑桥“十字征”Ⅰ期,“壳核裂隙征”Ⅱ期。结论:认为临床表现与头部MRI检查显示的新的影像学特征结合有助于MSA 早期 诊断。
英文摘要:
      Objective: To analyze the clinical manifestations as well as correlation between clinical manifestations and the new neuroimage characteristics (pontine"cross sign"and "putaminal slit")for early diagnosis of MSA. Methods:21 patients with diagnostic as multiple system atrophy (MSA) were retrospectively an analyzed for clinical manifestations and brain MRI findings.Results:In 21 patients with MSA,9 patients were MSA-A, eariy clinical manifestations of orthostatic hypotension,urogenital dysfunction, MRI showed stage Ⅰ"Cross sign "and" putaminal slit". 5 patients were MSA-C, early clinical appear unstable walking,ataxia and other performance, MRI showed stage Ⅱ"Cross sign "and stage Ⅰ" putaminal slit"after onset.7 patients were MSA-P,early clinical are bradykinesia,tremor and other performance,3 patients reached stage Ⅰ"Cross sign "and stage Ⅳ" putaminal slit" one years after onset, 3 patient reached stage Ⅰ"Cross sign "and stage Ⅰ" putaminal slit"two years after onset, another patient reached stage Ⅰ"Cross sign "and stage Ⅱ" putaminal slit" nine months after onset. Conclusions:Clinical manifestations and the new neuroimage characteristics were very important for early diagnosis of MSA.
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