周腦室白質軟化症之磁振造影表現－病例報告

Periventricular Leukomalacia of MR Images-Case Report

杜家宏(Chia-Hung Tu) ； 謝志明(Chih-Ming Hsieh) ； 梁恆(Joseph-Huang Leung)

《中華放射線技術學雜誌》 34卷2期 (2010/06) Pp. 90-94

https://doi.org/10.30045/CJRT.201006.0002

摘要

周腦室白質軟化症(Periventricular leukomalacia, PVL)發生原因不明，主要發生於早產兒，會因缺氧而損壞大腦白質影響大腦神經纖維發育，產生視覺傳導、認知及運動等機能障礙，主要診斷的工具有超音波(ultrasound)及磁振造影(MRI)。臨床上，PVL 患者在超音波檢查的影像，會出現囊泡狀或空洞，利用回聲不同的結果來進行診斷。而PVL患者在磁振造影檢查的影像，會表現出缺氧造成的腦室不規則形狀與白質受損的表現，與患者可能產生的機能障礙有著明顯的關係。於此，提出一例PVL病例，從磁振造影的影像表現、diffusion tensor image、3D TOF MRA及文獻所提出的相關病理解剖來進行討論。本病例在磁振造影的影像表現上，與參考文獻所指之病理位置相同，在DTI的表現上，大腦後半部表現神經纖維沒有正常發育的走向，這也是造成PVL患者視覺功能受損的主要區塊。除此之外，3D TOF MRA的影像表現出正常的血管結構，在文獻回顧裡沒有相關的討論。由於沒有足夠的病例，還需要更多的病例及追蹤以獲得證實。磁振造影檢查相較於超音波，能夠提供更多的訊息來做為診斷、後續治療及復健的依據。

並列摘要

The cause of periventricular leukomalacia is unknown, occurs mainly in preterm infant. Damage due to cerebral anoxia affecting the brain white matter fiber development, resulting in visual transduction, cognitive dysfunction, and activities .There are two main diagnostic tools include ultrasound and magnetic resonance imaging (MRI). Clinically, patients with PVL, the ultrasound shows cysts or hollow places in the brain tissue. The image for MRI shows irregular ventricular and white matter damage due to cerebral anoxia affecting. Hence, we present a case of PVL, from the performance of MRI imaging, diffusion tensor image (DTI), 3D TOF MRA and literature related to the proposed pathological anatomy for discussion. In this case, the image findings on MRI are the same locations as pathological references referred. Besides in the DTI performance, the performance of nerve fibers in the latter part of the brain behind the cerebrum does not have the normal growth trend, this also creates the main area which the PVL patient vision function suffers injury. In addition, 3D TOF MRA images show the normal vascular structures, but there are no discussions in the literature review. Because we don’t have sufficient cases, but also need more cases and tracing to obtain the confirmation. MRI compared with ultrasound can provide more information as the diagnosis, treatment and rehabilitation follow-up basis.

並列關鍵字

Periventricular leukomalacia ； PVL ； Diffusion tensor image ； MRI ； MRA