收稿日期:2011-12-19作者简介:陈志坚(1980-),男,学士,主治医师,主要从事放射诊断的研究。锥体束Wallerian变性的MRI诊断陈志坚,卜军,涂瑞芳(江西中医学院附属医院放射科,南昌330006)摘要:目的探讨MRI在诊断脑损害后锥体束Wallerian变性中的应用。方法对22例脑损害后锥体束Walle-rian变性患者均行MRI检查。常规行快自旋回波序列(FSE)横断位T1WI(TR2286ms,TE19.6ms)、T2WI(TR4300ms,TE113ms)和T2Flair序列(TR8502ms,TE133ms)。视野(FOV)24cm,矩阵320×256,激发次数(NEX)1~2,层厚6mm,层间距1mm,层数21层。22例患者均加扫横轴位DWI(b值为1000s·mm-2),其中10例另加扫3D-TOF-MRA(TR26ms,TE6.8ms)检查。结果22例患者中,12例患者在脑损害≥4周~≤12个月后行常规MRI检查,主要表现为病变同侧的锥体束呈长T1、长T2信号并同侧大脑脚及桥脑体积稍萎缩;2例患者在脑损害<4周行常规MRI检查,主要表现为病变侧锥体束稍长T1、长T2信号;8例患者在脑损害>1年行常规MRI检查,主要表现为原发病灶、大脑脚及桥脑萎缩并T2Flair像呈现散在斑片稍高信号影。结论MRI可明确显示脑损害后锥体束Wallerian变性,有助于临床医师对患者运动功能康复的治疗。关键词:脑损害;锥体束;Wallerian变性;MRI中图分类号:R814.42文献标志码:A文章编号:1009-8194(2012)02-0086-03MRIDiagnosisofWallerianDegenerationofPyramidalTractCHENZhi-jian,BUJun,TURui-fang(DepartmentofRadiology,theAffiliatedHospitalofJiangxiCollegeofTraditionalChineseMedicine,Nanchang330006,China)ABSTRACT:ObjectiveToexploretheapplicationofMRIdiagnosisofWalleriandegenerationofpyramidaltractafterbraininjury.MethodsTwenty-twopatientswithWalleriandegenerationofpyramidaltractafterbraininjuryunderwentMRIexamination(FSET1WITR/TE2286/19.6ms;T2WITR/TE4300/113ms;T2FlairsequenceTR/TE8502/133ms;FOV24cm;Ma-trix320×256;NEX1-2;slicethickness:6mm;interlayerspacing1mm;layers21).AnaxialDWIscan(bvalue1000s·mm-2)wasperformedinallpatients.Amongthem,3D-TOF-MRAexami-nation(TR/TE26/6.8ms)wasadditionallycarriedoutin10patients.ResultsAmongthe22pa-tients,12underwentMRIexaminationat≥4weeks-≤12monthsafterbraininjuryandshowede-longatedT1andT2signalsinpyramidaltractipsilateraltothelesionandslightatrophyofipsilat-eralcerebralpeduncleandpons.TwopatientsunderwentMRIexaminationat<4weeksafterbraini...