Signal changes in cortical laminar necrosis-evidence from susceptibility-weighted magnetic resonance imaging
Signal changes in cortical laminar necrosis-evidence from susceptibility-weighted magnetic resonance imaging
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DOI：
10.1007/s00234-009-0497-8
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发表时间：
2009-05-01
期刊：
影响因子：
2.8
通讯作者：
Patro, Satyanarayana
中科院分区：
文献类型：
--
作者：
Kesavadas, Chandrasekharan;Santhosh, Kannath;Patro, Satyanarayana
根据导致其产生的情况，可以将梗塞分为两种类型：伴有全坏死的梗塞和伴有选择性神经元损失的梗塞。皮质层状坏死（CLN）可由多种病因引起，其中最常见的是梗死和缺氧。梗塞导致全坏死，而缺氧和不完全梗塞导致选择性神经元损失，并存在活细胞、神经胶质增殖和顺磁性物质沉积。我们采用磁敏感加权成像 (SWI) 技术对 CLN 患者进行了研究，该技术对微量顺磁剂或出血成分高度敏感。我们根据标准标准回顾性审查了诊断为 CLN 的患者的医疗记录。记录了人口统计特征和病因。对包括 SWI 在内的磁共振图像结果进行了分析。我们确定了 11 名 CLN 患者，其中 6 名男性和 5 名女性，年龄范围为 4-64 岁。病因包括两名患者的缺氧和九名患者的梗死。 SWI 检测到 CLN 中由于缺氧缺血性脑病而沿脑回边缘出现弥漫性线性低信号。在一名梗塞患者中发现线性点状低信号。由于缺氧缺血性脑病导致的 CLN 显示线性脑回低信号和基底节低信号，这些在 SWI 中可识别，可能代表矿化。这可能与铁从基底神经节穿过幸存的神经元到皮质的转运有关，这在完全梗死的情况下是不可能的。 SWI 可能有助于了解完全梗塞和缺氧导致的 CLN 的病理生理学方面。
Two types of infarcts can be identified depending on the circumstances leading to its generation-infarcts with pannecrosis and infarcts with selective neuronal loss. Cortical laminar necrosis (CLN) can occur due to various etiologies of which infarctions and hypoxia are the commonest. Infarction results in pannecrosis whereas hypoxia and incomplete infarction result in selective neuronal loss with the presence of viable cells, glial proliferations, and deposition of paramagnetic substances. We investigated patients with CLN with susceptibility-weighted imaging (SWI), a technique highly sensitive to even traces of paramagnetic agents or hemorrhagic components.We retrospectively reviewed medical records of patients diagnosed with CLN as per standard criterion. Demographic characteristics and etiologies were recorded. Findings in magnetic resonance images including SWI were analyzed.We identified 11 patients with CLN, six males and five females with age range of 4-64 years. Etiologies included hypoxia in two patients and infarction in the nine patients. SWI detected diffuse linear hypointensities along the gyral margins in CLN due to hypoxic ischemic encephalopathy. Linear dot like hypointensities were identified in one patient with infarction.CLN due to hypoxic ischemic encephalopathy display linear gyral hypointensities and basal ganglia hypointensities that are identifiable in SWI and may represent mineralization. This might be related to iron transport across the surviving neurons from basal ganglia to the cortex, which is not possible in complete infarction. SWI may be helpful in understanding the pathophysiological aspects of CLN due to complete infarction and hypoxia.