酒依赖致慢性酒精中毒性脑病的临床及CT/MRI分析

目的:分析酒依赖致慢性酒精中毒性脑病(CAE)的临床及CT/MRI影像表现特征,探讨CT/MRI在该病临床诊断中的价值。方法:回顾性分析32例资料完整CAE患者的临床及CT/MRI影像学资料,总结其影像学表现特征。结果:CAE临床表现主要为不同程度的神经系统损害(尤为中枢神经系统)和精神障碍,其颅脑损害CT/MRI主要表现为:脑萎缩27例;脑梗塞7例;白质脱髓鞘18例;韦尼克脑病3例;胼胝体变性1例;多病变并存24例。结论:①CAE的病理机制为饮酒导致的脑血管损害和营养代谢障碍,以及脑组织缺血缺氧、神经纤维脱髓鞘改变;②CAE影像学表现有其特征性,尤以小脑蚓部萎缩以及韦尼克脑病、胼胝体变性更具特征性,CT/MRI检查对了解脑损害的性质、范围及程度有重要意义,可为临床诊断、治疗及评估预后提供依据。

Clinical CT/MRI Analysis of Chronic Alcoholism Encephalopathy Caused by Alcohol Dependence

Objective：To analyze the clinical and imaging characteristics of chronic alcoholism encephalopathy（CAE） due to Alcohol dependence,to explore the clinical diagnosis value in the disease.Methods：A retrospective analysis of clinical and CT,MRI imaging data of 32 cases complete data in patients of CAE,its imaging features were concluded.Results：CAE is characterized by different degrees of nervous system damage（especially the central nervous system） and mental disorders;the brain damage mainly shows in CT,MRI：27 cases of brain atrophy;7 cases of cerebral infarction;18 cases of white matter demyelization;3 cases of Wernicke＇s encephalopathy;1 cases of Marchiafava-Bignami disease;24 cases of multiple lesions coexist.Conclusion：a） It is the mainly pathological mechanisms in CAE occurred that alcohol use leading to brain vessels damage and nutrient metabolism disorder,brain tissue ischemia and hypoxia and nerve fiber demyelinationis.b） CAE imaging has its own characteristic,especially cerebellar vermis atrophy,Wernicke＇s encephalopathy and Marchiafava-Bignami disease is more characteristic,there were great significance in understanding the nature,scope and degree of brain damage by CT,MRI examination.It is an important basis in the clinical diagnosis,treatment and prognosis of evalulation.