中国全科医学 ›› 2021, Vol. 24 ›› Issue (27): 3510-3517.DOI: 10.12114/j.issn.1007-9572.2021.00.493

• 专题研究 • 上一篇    下一篇

成年人脑白质病变的分类和临床特点综述

韩佳琦,王伟*   

  1. 100053北京市,首都医科大学宣武医院神经内科
    *通信作者:王伟,副主任医师;E-mail:sunnywangwei@163.com
  • 出版日期:2021-09-20 发布日期:2021-09-20

Classification and Clinical Characteristics of Adulthood Leukoencephalopathies 

HAN Jiaqi,WANG Wei*   

  1. Department of Neurology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China
    *Corresponding author:WANG Wei,Associate chief physician;E-mail:sunnywangwei@163.com
  • Published:2021-09-20 Online:2021-09-20

摘要: 成年人脑白质病变是在成年期起病的脑白质的病理性改变,其鉴别诊断仍是神经内科医生面临的重点和难点之一。本文主要从病因角度对成年人脑白质病变进行了细化分类,并概述了常见成年人脑白质病变的临床及影像学表现、诊断和治疗手段等,强调了细化脑白质病变的分类对临床精准诊疗的重要性,认为颅脑影像学检查是鉴别脑白质病变的重要手段,且结合脑脊液、病理检查、脑代谢检测和二代测序技术等辅助检查手段有助于提高临床诊断效率。

关键词: 脑白质病, 脑白质营养不良, 遗传性, 获得性, 磁共振成像, 综述

Abstract: Adulthood leukoencephalopathies are pathological changes of white matter with adult-onset,of which the differential diagnosis is still one of the key points and difficulties faced by neurologists. In this paper,these leukoencephalopathies are classified from etiololgy perspective. The clinical and imaging manifestations,diagnosis and treatments of common leukoencephalopathies are summarized. This article emphasizes the importance of detailed classification of leukoencephalopathies for precise clinical diagnosis and treatment. It is considered that craniocerebral imaging is an important means to identify different leukoencephalopathies,which combined with cerebrospinal fluid testing,histopathological examination,brain metabolism testing,next generation sequencing and other auxiliary methods can further improve the diagnostic efficiency.

Key words: Leukoencephalopathies, Leukodystrophy, Hereditary, Acquired, Magnetic resonance imaging, Review