自身免疫性胶质纤维酸性蛋白星形细胞病MRI表现
MRI and clinical manifestations of autoimmune glial fibrillary acidic protein astrocytopathy
马俊楠 1姜传武 2李厚颖 1刘平3
作者信息
- 1. 山东大学第二医院影像科 山东 济南 250033
- 2. 青岛大学附属青岛市海慈医院影像科 山东 青岛 266033
- 3. 山东中医药大学第二附属医院放射科 山东 济南 250001
- 折叠
摘要
目的 探讨自身免疫性胶质纤维酸性蛋白星形细胞病(GFAP-A)的影像学特点.方法 选取经临床证实的 5例自身免疫性GFAP-A患者的MRI表现并进行文献复习.结果 5 例患者中 4 例行颅脑MRI平扫及增强扫描,4 例行颈胸腰髓MRI平扫及增强扫描,1 例行颈胸腰髓MRI平扫.2 例患者颅脑MRI显示病变位于小脑半球、侧脑室旁白质,注射对比剂后,显示小脑半球放射状线样强化,侧脑室旁白质内垂直于侧脑室的线样强化;1 例患者颅脑MRI强化图像可见颞叶、枕叶软脑膜线样强化.2 例颅脑MRI平扫及增强未见异常.5 例患者脊髓MRI显示病变累及脊髓,T2WI表现为斑片状高信号.注射对比剂后病变呈轻度强化.结论 GFAP-A临床少见,症状缺乏特异性,MRI检查具有较大的临床应用价值,结合实验室检查,可提高诊断准确率,避免误诊.
Abstract
Objective To investigate the imaging characteristics and clinical diagnosis of autoimmune glial fibrillary acidic proteinastrocytopathy(GFAP-A).Methods The magnetic resonance(MR)images of 5 patients with clinically confirmed GFAP-A were retrospectivelyanalyzed,and literatures were reviewed.Results Among the 5 patients,4 underwent cranial MR plain scan and enhanced scan,4 underwent spinalMR plain scan and enhanced scan,and 1 underwent spinal MR plain scan.In the 5 cases of GFAP-A,the brain MR image lesions mainly located in the cerebellum and periventricular white matter.After contrastin-jection,the MR images showed that the lesions were radial lineargadolinium enhancement in the cerebellum and linear gadolini-umenhancement in the white matter perpendicular to the ventricle in 2patients.Spine MRI images revealed longitudinally exten-sive spinalcord lesions.The lesions showed hyperintensity on T2WI.On enhanced scan,the lesions were slightly enhanced.Conclusion GFAP-A is relatively rare.Clinical manifestations are lack of specificity.MR examination has great clinical value.Combined with laboratory examination can improve the diagnostic accuracy and avoid misdiagnosis.
关键词
自身免疫性胶质纤维酸性蛋白星形细胞病/磁共振成像/诊断Key words
Autoi mmune glial fibrillary acidic protein astrocytopathy/Magnetic resonance imaging/Diagnosis引用本文复制引用
出版年
2024
NETL
NSTL
万方数据