一文读懂!“雪山征”——CADASIL的病理、临床和影像

2022-05-31 华夏影像诊断中心 华夏影像诊断中心

一起来学习~

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先看两个病例:

病例一:

女,70岁,糖尿病,复视10天。21年前有相同症状。 

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病例来源:忻州影像群、任武科老师  

 

病例二:

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病例来源:忻州影像群,刘金牛老师

 

以上两个病例变现为“雪山征”,皮层下白质梗死,脑白质病变

诊断意见:CADASIL

 

接下来我们一起学习一下这方面的资料:

来源:东南大学附属中大医院放射,王涛、郑力老师

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1752032, encodeId=829e1e5203250, content=<a href='/topic/show?id=15ba396ece' target=_blank style='color:#2F92EE;'>#CADASIL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3967, encryptionId=15ba396ece, topicName=CADASIL)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e99536423166, createdName=sunmin0231, createdTime=Tue Sep 13 22:11:50 CST 2022, time=2022-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1224192, encodeId=7400122419275, content=意义何在, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210720/4def855001b344a580dbfd5c54b41e6a/bd37a67a530043c8bfa92e7e39aaa9b0.jpg, createdBy=92265553280, createdName=ms5000000505546636, createdTime=Fri Jun 03 04:06:19 CST 2022, time=2022-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1264798, encodeId=de991264e985c, content=<a href='/topic/show?id=150f19229c' target=_blank style='color:#2F92EE;'>#ADA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1922, encryptionId=150f19229c, topicName=ADA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ad9f79, createdName=般若傻瓜, createdTime=Thu Jun 02 14:11:50 CST 2022, time=2022-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1223797, encodeId=07901223e979d, content=脑小血管病一部分也有基因异常引起的,学习了 , beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e3e76499938, createdName=ms6000001791212108, createdTime=Wed Jun 01 10:03:56 CST 2022, time=2022-06-01, status=1, ipAttribution=)]
    2022-06-03 ms5000000505546636

    意义何在

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1752032, encodeId=829e1e5203250, content=<a href='/topic/show?id=15ba396ece' target=_blank style='color:#2F92EE;'>#CADASIL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3967, encryptionId=15ba396ece, topicName=CADASIL)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e99536423166, createdName=sunmin0231, createdTime=Tue Sep 13 22:11:50 CST 2022, time=2022-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1224192, encodeId=7400122419275, content=意义何在, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210720/4def855001b344a580dbfd5c54b41e6a/bd37a67a530043c8bfa92e7e39aaa9b0.jpg, createdBy=92265553280, createdName=ms5000000505546636, createdTime=Fri Jun 03 04:06:19 CST 2022, time=2022-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1264798, encodeId=de991264e985c, content=<a href='/topic/show?id=150f19229c' target=_blank style='color:#2F92EE;'>#ADA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1922, encryptionId=150f19229c, topicName=ADA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ad9f79, createdName=般若傻瓜, createdTime=Thu Jun 02 14:11:50 CST 2022, time=2022-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1223797, encodeId=07901223e979d, content=脑小血管病一部分也有基因异常引起的,学习了 , beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e3e76499938, createdName=ms6000001791212108, createdTime=Wed Jun 01 10:03:56 CST 2022, time=2022-06-01, status=1, ipAttribution=)]
    2022-06-02 般若傻瓜
  4. [GetPortalCommentsPageByObjectIdResponse(id=1752032, encodeId=829e1e5203250, content=<a href='/topic/show?id=15ba396ece' target=_blank style='color:#2F92EE;'>#CADASIL#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3967, encryptionId=15ba396ece, topicName=CADASIL)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e99536423166, createdName=sunmin0231, createdTime=Tue Sep 13 22:11:50 CST 2022, time=2022-09-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1224192, encodeId=7400122419275, content=意义何在, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210720/4def855001b344a580dbfd5c54b41e6a/bd37a67a530043c8bfa92e7e39aaa9b0.jpg, createdBy=92265553280, createdName=ms5000000505546636, createdTime=Fri Jun 03 04:06:19 CST 2022, time=2022-06-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1264798, encodeId=de991264e985c, content=<a href='/topic/show?id=150f19229c' target=_blank style='color:#2F92EE;'>#ADA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1922, encryptionId=150f19229c, topicName=ADA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ad9f79, createdName=般若傻瓜, createdTime=Thu Jun 02 14:11:50 CST 2022, time=2022-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1223797, encodeId=07901223e979d, content=脑小血管病一部分也有基因异常引起的,学习了 , beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e3e76499938, createdName=ms6000001791212108, createdTime=Wed Jun 01 10:03:56 CST 2022, time=2022-06-01, status=1, ipAttribution=)]
    2022-06-01 ms6000001791212108

    脑小血管病一部分也有基因异常引起的,学习了

    0

相关资讯

Neurology:急性低血压可以加速CADASIL病理进展!

研究结果表明急性低血压的血管反应性受损可以加速CADASIL病理进展。此外,受影响白质区域的静脉胶原病在维护白质完整性上发挥了重要作用,虽然在很大程度上被忽视。

Stroke:CADASIL患者软脑膜动脉存在显著的内膜增生但管腔不狭窄

CADASIL软脑膜动脉存在显著的内膜增生但没有管腔狭窄 软脑膜动脉异常还没有专门列为CADASIL(伴皮层下梗死和脑白质病变的常染色体显性遗传性脑动脉病)的一个特征。为此,美国密歇根大学神经科的Hairong Dong博士等人进行了一项研究,研究结果在线发表在2013年3月12日的Stroke杂志上。研究结果显示:CADASIL软脑膜动脉的主要改变包括内膜增厚和中膜变薄,但不包括管腔变窄。

Stroke:CADASIL患者的局部宏观皮质病变

由此可见,在CADASIL患者发展到最后阶段之前很长一段时间内,局部宏观皮质病变可以通过使用特定的磁共振成像方法来进行检测。这些皮质变化的潜在机制和精确的临床结局仍然需要进一步研究来确定。

Stroke:CADASIL患者大脑微出血与缺血性卒中风险有何关系!

由此可见,微出血的存在是CADASIL患者发生缺血性卒中的一个独立危险标志,这一发现强调了需要仔细解读MRI数据。

Stroke:不同类型的脑小血管病的皮质表面铁沉积症!

由此可见,cSS在CADASIL患者中是不存在的,而其他的小血管病变的影像学特征与有cSS的CAA患者相似。该研究结果表明cSS结合其他小血管疾病的影像学标记对CAA具有高度指示性价值。

JNNP:7TPC-MRA评估CADASIL患者豆状动脉血流速度

CADASIL(cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy)即