Neurology:叉骨形铁沉积:GM1神经节苷脂贮积症的典型影像学征象

2019-05-27 zyx整理 神经科病例撷英拾粹

8岁女孩,发育史和家族史无殊,自3岁起出现进行性口舌和肢体肌张力障碍。脑MRI可见双侧壳核后部体积减少和高信号。

8岁女孩,发育史和家族史无殊,自3岁起出现进行性口舌和肢体肌张力障碍。脑MRI可见双侧壳核后部体积减少和高信号。磁敏感加权成像可见苍白球低信号,呈特征性的叉骨样外观,内侧部和外侧部形成叉状末端(图)。脊柱MRI可见伴扁椎骨和椎体鸟嘴样改变的骨发育不良特征。β-半乳糖苷酶水平较低,遗传学检测提示GLB1基因存在复合杂合致病突变。 结合壳核发现和铁叉骨形沉积,高度提示晚发型/3型GM1神经节苷脂贮积症的诊断,有助于和其他脑组织铁沉积神经变性病区别。



(图:A:T2WI可见壳核后部高信号以及体积减少;B-C:SWI和示意图可见苍白球低信号呈叉骨样外观;C-D:脊柱T2WI和颈椎X线片可见扁椎骨[*]和椎骨鸟嘴样改变[箭];F:骨盆X线片提示双侧髋外翻)

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