疤痕狀腦回－磁振造影之發現

MRI Findings of Ulegyria

沈戊忠(Wu-Chung Shen) ； 陳啓昌(Chi-Chan Chen) ； 何永仁(Yung-Jen Ho) ； 李三剛(San-Kan Lee) ； 李寬容(Kuan-Rong Lee)

《中華放射線醫學雜誌》 18卷4期 (1993/12) Pp. 357-363

摘要

疤痕狀腦回(ulegyria)係指大腦皮質之結疤化(scarring)，通常是因出生時或嬰兒期受缺氧性－缺血性腦傷害所引起。這種腦回在屍體解剖時可見腦回萎縮，不規則，被稱「蕈茹狀」(mushroom like)。本文報告20例以MRI偵測出有疤痕狀腦回之患者。其中8例之原因為週產期窒息所造成的後遺症；8例為嬰兒期頭部外傷（20天到8個月大時發生）之後遺症，這8例中有3 系列的CT及MRI証實合併內頸動脈及顱內大動脈栓塞；另4例為嬰兒期腦膜炎之後遺症，其引起疤痕狀腦回的原因可能是腦膜炎（3天到7個月大時發生）合併動脈炎引起動脈梗塞之腦缺氧。
所以儘管引起疤痕狀腦回有三種不同之原因，但其相同的致病機轉乃是出生時及嬰兒期（8個月以內）之缺氧性－缺血性腦傷害所引起的後遺症。

關鍵字

腦部磁振造影檢查 ； 腦部病變 ； 腦部缺血 ； 腦部外傷 ； 嬰幼兒神經系統

並列摘要

The term ”ulegyria” (gyral scarring) refers to the scarring of the cerebral cortex following hypoxic-ischemic insult in perinatal stage or early life. The gyri have been described as ”mushroom” like. It is easily recognized by gross inspection during brain cutting and by MRI. Here we report 20 cases of ulegyria diagnosed by MRI. Eight cases were caused by perinatal and neonatal asphyxia, one case had hypoxia of brain at 8 months of life, and eight cases were caused by infantile head injury (2 to 8 months old). Three cases of infantile head injury had serial CT and MRI follow-up, which proved post-traumatic thrombosis. Four cases were the sequela of infantile meningitis (3 days to 7 months old).
Despite the different etiologies, the pathogenesis of ulegyria is hypoxic-ischemic insult in the infantile brain before eight months of life.
Ulegyria in asphyxia cases occurs in the parasagittal watershed areas, whereas ulegyria in infantile head injury and meningitis occurs in the territory of involving arteries.

並列關鍵字

Brain, MRI ； brain, disease ； brain, ischemia ； brain, injury ； children and infants, nervous system