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目的分析散发性Creutzfeldt-Jakob病(sCJD)的影像学特征,旨在提高临床医生对此病的认识和诊断水平。方法总结河北医科大学附属唐山工人医院2004—2009年临床诊断为sCJD的患者7例,对其病后第1～12个月进行头部影像学检查(CT、MRI)。结果所有患者头部CT检查未见底节区异常改变,3例可见脑萎缩;头部MRI检查可见1例双侧尾状核、壳核于T2加权像(T2WI)高信号,3例FLAIR序列呈对称性高信号,T1加权像无改变;6例分别可见双侧尾状核、壳核、丘脑弥散加权成像(DWI)上可见对称性高信号,2例DWI上可见皮层不对称性高信号,且异常信号随病情时间进展而变化。结论 sCJD临床表现以快速发展的进行性痴呆和肌阵挛最具特点,其影像学异常改变在特定的临床背景下可成为sCJD临床诊断依据之一。
Objective To analyze the imaging features of sporadic Creutzfeldt-Jakob disease (sCJD) to improve clinicians’ understanding and diagnosis of the disease. Methods Seven patients with clinically diagnosed sCJD from 2004 to 2009 at Tangshan Workers Hospital of Hebei Medical University were enrolled in this study. CT and MRI were performed on the first to the twelfth months after their illness. Results All patients had abnormal CT scan of the head, and brain atrophy was observed in 3 cases. One case of bilateral caudate nucleus was found in MRI examination of the head. The nuclei were hyperintense on T2 weighted images (T2WI) and 3 cases of FLAIR High symmetry signals and no significant change in T1 weighted images. High symmetry signals were seen in bilateral nucleus caudatum, putamen, thalamic diffuse weighted imaging (DWI) in 6 cases and high signal asymmetry in 2 cases on DWI , And the abnormal signal changes with the progress of the disease time. Conclusion The clinical manifestations of sCJD are characterized by the rapid development of progressive dementia and myoclonus. The abnormal imaging changes may become the basis of clinical diagnosis of sCJD in a specific clinical setting.