专题双侧基底节及丘脑病变的鉴别诊断
2020-10-21 来源：不详 浏览次数：次让学习成为一种习惯！
医学影像服务中心国内最大的医学影像专业平台，唯一拥有例病例+征象及专题讲座。
来源：熊猫放射
翻译：花人青（授权发送）
解剖
正常信号及表现
病种英文名
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小结
原文摘要：
Thebasalgangliaandthalamusarepaireddeepgraymatterstructuresthatmaybeinvolvedbyawidevarietyofdiseaseentities.Thebasalgangliaarehighlymetabolicallyactiveandaresymmetricallyaffectedintoxicpoisoning,metabolicabnormalities,andneurodegenerationwithbrainironaccumulation.Boththebasalgangliaandthalamusmaybeaffectedbyothersystemicormetabolicdisease,degenerativedisease,andvascularconditions.Focalflavivirusinfections,toxoplasmosis,andprimarycentralnervoussystemlymphomamayalsoinvolvebothdeepgraymatterstructures.Thethalamusismoretypicallyaffectedalonebyfocalconditionsthanbysystemicdisease.Radiologistsmaydetectbilateralabnormalitiesofthebasalgangliaandthalamusindifferentacuteandchronicclinicalsituations,andalthoughmagneticresonance(MR)imagingisthemodalityofchoiceforevaluation,thecorrectdiagnosiscanbemadeonlybytakingallrelevantclinicalandlaboratoryinformationintoaccount.TheneuroimagingdiagnosisisinfluencednotonlybydetectionofspecificMRimagingfeaturessuchasrestricteddiffusionandthepresenceofhemorrhage,butalsobydetectionofabnormalitiesinvolvingotherpartsofthebrain,especiallythecerebralcortex,brainstem,andwhitematter.Judicioususeofconfirmatoryneuroimaginginvestigations,especiallydiffusion-weightedimaging,MRangiography,MRvenography,andMRspectroscopyduringthesameexamination,mayhelpimprovecharacterizationoftheseabnormalitiesandhelpnarrowthedifferentialdiagnosis.
Conclusions
Systemicandmetabolicabnormalitiesofteninvolvethebasalgangliaorthalamusonbothsides,andcarefulassessmentofbrainabnormalitiesoccurringsimultaneouslyoutsidethesestructuresisimportant.CTandMRimaging,includingT1-weightedimaging,diffusion-weightedimaging,MRangiography,MRvenography,andMRspectroscopy,areoftenhelpfulinnarrowingthedifferentialdiagnosis.Oftentimes,however,thediagnosisisnotstraightforward,andthecorrelationoftypicalimagingfeatureswithclinicalandlaboratorydatacanhelpmakethecorrectdiagnosis(Table).
