绿皮包[GBS转].docVIP

格林巴利综合征 (Guillain-Barre syndrome)MRI病例图片影像诊断分析 ?【临床病史】：患者，10岁男孩，近期病毒感染，出现下肢麻痹和反射减弱。CSF检查提示蛋白含量增高，不伴有脑脊液细胞增多。10-year-old male with recent viral infection is admitted with lower extremity paralysis and hyporeflexia. CSF findings reveal elevated protein level without pleocytosis. 【 HYPERLINK / \t _blank 影像图片】MRI图像 ?? 【 HYPERLINK / \t _blank 影像表现】：Figure 1,Figure 2,Figure 3and Figure 4: When compared with pre-contrast T1 weighted sagittal images (Figure 3), post-gadolinium sagittal T1-weighted images demonstrate enhancement and thickening of the cauda equina (Figure 4).对比平扫T1和增强矢状位T1显示马尾增厚强化。 【 HYPERLINK /diagnosis/ \t _blank HYPERLINK / \t _blank 影像诊断】：Guillain-Barre syndrome 格林巴利综合征 Differential diagnosis of abnormal intrathecal nerve root enhancement includes: 异常的鞘内神经根强化鉴别诊断包括：1.AIDS-related polyradiculopathy AIDS相关的多发性神经根病；2.Arachnoiditis 蛛网膜炎；3.Sarcoidosis 结节病；4.Metastatic disease 转移性病变。 【诊断要点】： Guillain Barre syndrome is a heterogeneous grouping of immune-mediated processes generally characterized by motor, sensory, and autonomic dysfunction. Classically, GBS is an acute inflammatory demyelinating polyneuropathy characterized by progressive symmetric ascending muscle weakness, paralysis, and hyporeflexia with or without sensory or autonomic symptoms; however, variants involving the cranial nerves or pure motor involvement are not uncommon.? 格林巴利综合征是一种免疫介导的多类型病变，一般特征为运动、感觉及自主功能障碍。典型的情况下，GBS是一种急性炎症性脱髓鞘性多发性神经病，表现为急性进行性对称的逐步向上延伸的肌无力、瘫痪和反射减弱，伴有或不伴有感觉或自主功能障碍。然而其他类型-颅神经或单纯的运动神经受累并非罕见。 ??? MRI of the thoracolumbar spine is performed in cases of equivocal CSF and EEG findings or atypical clinical presentation.? MRI findings include abnormal thickening and enhancement of the intrathecal nerve roots and cauda equina.? The enhancement of only anterior spinal nerve roots is strongly suggestive of Guillain Barre syndrome. MRI is a sensitive but non-specific examination. 当CSF和EEG检查疑诊或临床症状不典型时需要行胸腰椎MR扫描。MRI表现包括异常增粗强化的鞘内神经根和马尾。仅仅是前方的神经根强化强烈的提示GBS。MRI是一种敏感但并不特异的检查。 【讨论】：Guill