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논문 상세정보

뇌피질 층상괴사의 자기공명영상 소견

MRI Findings of Cortical Laminar Necrosis

Abstract

Purpose : To evaluate the characteristic sequential MRI findings of cortical laminar necrosis Materials andMethods : We retrospectively reviewed the MRI findings of 11 patients with clinical signs of hypoxic brain damagewho showed findings of cortical laminar necrosis with definite time of onset. Three were men and eight were women; they were aged between 27 and 74 (mean 59.3)years. All patients underwent imaging with a 1.0-T MagnetomImpact(Siemens) ; follow-up MR examinations were performed in five. Results : The watershed zones in theparietooccipital, frontoparietal and temporoparietal cortex were involved in eight cases, whereas the other areasinvolved were the frontal lobe in two cases and the temporal lobe in one. In one case, MRI obtained two days latershowed brain swelling demonstrating obliteration of cortical sulci and high signal intensity of subcortical whitematter on T2WI. In five cases, MRI obtained between two and three weeks later showed gyriform high signalintensity along the cortex on T1WI, cortical high and subcortical low signal intensities on T2WI in four cases,and gyriform enhancement on gadolinium-enhanced scans in three cases. MRI obtained between three and four weekslater in three cases showed subcortical high signal intensity on T2WI in two cases and gyriform cortical highsignal intensities on T1WI and gyral enhancement in all cases. MRI obtained after 50 days in four cases includingtwo of follow-up MR, showed cortical gyriform high signal intensity on T1WI in all cases and subcortical highsignal intensity on T2WI and mild gyriform enhancement on gadolinium-enhanced scans in three cases. In twofollow-up studies, the lesions had become more discrete and larger. Conclusion : Cortical laminar necrosis due tohypoxic brain damage shows relatively characteristic MR findings according to the stage. Therefore, MR imagingseems to be useful diagnostic tool for the evaluation of cortical laminar necrosis due to hypoxic brain damage.

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