目的:探讨临床表现,诊断,治疗,糖尿病性纹状体病(DS)的发病机制,提高对该病的认识,避免误诊或漏诊。
方法:临床,实验室,回顾性分析6例(5例亚洲女性和1例亚洲男性)糖尿病纹状体的影像学资料,并对相关文献进行了综述。
结果:所有6例患者均出现高血糖,5例患者表现为单侧肢体不自主运动,1伴有单侧肢体麻木。此外,5例患者(病例3除外)接受了MRI检查,在T1加权图像上显示单侧尾状核和扁形核的高强度。6例接受脑部CT检查的患者均显示单侧尾状核和叶状核的高密度或等密度。没有人有类似异常运动的家族史。血糖控制和对症支持治疗后,所有患者的症状都有不同程度的改善,复查显示病灶逐渐消失。
结论:糖尿病纹状体疾病是糖尿病的一种罕见并发症,不同发病机制组合的结果。它的特点是高血糖,半球虫,和对侧纹状体T1WI高强度或CT高密度。酮症和非酮症高血糖偏球症均有典型的影像学表现。当这种疾病早期发现时,预后很好,随着血糖控制,病变可以逐渐吸收和消散。
OBJECTIVE: To explore the clinical manifestations, diagnosis, treatment, and pathogenesis of diabetic striatopathy (DS) to improve the understanding of the disease and avoid misdiagnosis or underdiagnosis.
METHODS: The clinical, laboratory, and imaging data of 6 patients (5 Asian females and 1 Asian male) with diabetic striatum were analyzed retrospectively, and the related literature was reviewed.
RESULTS: All 6 patients showed hyperglycemia, 5 patients presented with involuntary movement of unilateral limbs, and 1 with unilateral limb numbness. Besides, 5 patients (except case 3) underwent MRI examinations that showed hyperintensity in unilateral caudate and lentiform nucleus on T1-weighted images. And all 6 patients who underwent brain CT examinations showed hyperdensity or isodensity in unilateral caudate and lentiform nucleus. None had a family history of similar abnormal movements. After blood glucose control and symptomatic support treatment, the symptoms of all patients improved to various degrees, and reexaminations showed that the lesions gradually disappeared.
CONCLUSIONS: Diabetic striatal disease is a rare complication of diabetes mellitus, the result of a combination of different pathogenesis. It is characterized by hyperglycemia, hemichorea, and contralateral striatal T1WI hyperintensity or CT hyperdensity. Both ketosis and nonketotic hyperglycemic hemichorea have typical imaging manifestations. The prognosis is excellent when this disease is detected early, and the lesions can be gradually absorbed and dissipated with glycemic control.