Neurology：1例与卒中后延迟钆渗漏相关的血管周围和蛛网膜下腔液体衰减反转恢复序列高信号

2022-09-11 神经科病例撷英拾粹神经科病例撷英拾粹

74岁男性，表现为右侧分水岭梗死（初始钆注射MRI，图）。肾功能正常。4小时后的MRI可见同侧血管周围间隙（PVS）和蛛网膜下腔液体衰减反转恢复序列（FLAIR）高信号，很可能与卒中相关的延迟钆渗漏有

74岁男性，表现为右侧分水岭梗死（初始钆注射MRI，图）。肾功能正常。4小时后的MRI可见同侧血管周围间隙（PVS）和蛛网膜下腔液体衰减反转恢复序列（FLAIR）高信号，很可能与卒中相关的延迟钆渗漏有关（图）。10天后的MRI可见蛛网膜下腔/血管周围异常完全消退（图）。

FLAIR上卒中相关的蛛网膜下腔和眼部钆渗漏很可能代表血-脑/眼屏障破坏。较早的一则报道描述了卒中后超过1个月的MRI上的PVS钆渗漏。在蛛网膜下腔和PVS中观察到的与卒中相关的血-脑屏障渗漏可能涉及类淋巴系统（在 CSF-间质液交换中发挥作用）。

（图：初始MRI[注射钆用于磁共振血管造影]可见右侧梗死[A：弥散加权成像]和血管周围间隙[PVS][B：T1加权成像；C：液体衰减反转恢复序列（FLAIR）]；D-F：4小时后，MRI可见同侧蛛网膜下腔[箭]和深部和皮质下PVS[箭头]钆渗漏，表现为FLAIR高信号；G-I：10天后观察到蛛网膜下腔/血管周围FLAIR异常完全消退）

参考文献

Nistorec L, Renard D, Parvu T. Perivascular and Subarachnoid Fluid-Attenuated Inversion Recovery Hyperintensities Related to Delayed Gadolinium Leakage After Stroke. Neurology. 2021 Nov 23;97(21):1000-1001.

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2022-11-02 yinhl1978

#Neurol#

130 0
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2022-11-10 waiwai3039

#卒中后#

97 0
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2023-08-14 aliceclz

#蛛网膜#

92 0
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2023-02-11 meichuangyi

#高信号#

98 0
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2022-09-11 1462c028m99(暂无昵称)

学习了

105 0
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Neurology：1例与卒中后延迟钆渗漏相关的血管周围和蛛网膜下腔液体衰减反转恢复序列高信号

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