Objective To investigate the value of high-resolution magnetic resonance imaging (HRMRI) in the etiological diagnosis of top of the basilar syndrome (TOBS).Methods Thirty patients with TOBS performed conventional MRI,magnetic resonance angiography (MRA),and HRMRI of vertebrobasilar arteries,and their images were analyzed.Results MRA revealed that 18 patients with TOBS had vertebrobasilar stenosis or occlusion.Eleven of them had vertebral artery stenosis or occlusion and 7 had basilar artery stenosis or occlusion.HRMRI suggested that 21 patients had plaque formation in vertebrobasilar arteries,including 3 TOBS patients with negative MRA,and their abnormal vascular walls and plaque formation were observed.Conclusions Vertebrobasilar stenosis and plaque formation are the important pathological bases of TOBS.HRMRI can clearly reveal the vascular wall structure of the intracranial arteries and compensate for the lack of conventional MRA techniques.It has a guiding value for the etiologic diagnosis of posterior circulation infarction,including TOBS.

Objective To investigate the properties and remodeling pattern of basilar artery atherosclerosis in paramedian pontine infarction(PPI) with 3.0T high-resolution magnetic resonance imaging(HRMRI). Methods Thirty consecutive patients with acute paramedian pontine infarction were enrolled from January 2011 to December 2012, all are detected by conventional magnetic resonance imaging(MRI) and magnetic resonance angiography(MRA), and HRMRI was performed on the target segment by using a 3.0T MR scanner. Remodeling index(RI) was calculated as vessel area at maximal lumen narrowing(MLN)/reference vessel area. RI≤0.95 was defined as negative remodeling(NR), 0.95<RI<1.05 as intermediate remodeling(IR), and RI≥1.05 as positive remodeling(PR), wall characteristics were compared between the NR and PR group. Results In 30 patients, 9 arteries were shown stenosis, 21 arteries were shown normal on MRA, while HRMRI detected 25 arteries with plaque, and the basilar artery(BA) plaques at or near the origin of the penetrating artery. Analyze the 25 patients, NR was found in 8 patients, IR in 6 patients, and PR in 11 patients. At MLN sites, compared with lesions with NR, lesions with PR had greater plaque area([8.17±4.7]mm2vs [1.08±1.89]mm2, P<0.01), and a greater percent plaque burden([29.07±15.03]% vs [3.96±6.76]%, P<0.01). Conclusion HRMRI can help assess subtypes of ischemic stroke and the remodeling pattern of BAatherosclerosis. Etiology of PPI is the BA plaque blocking the penetrating artery. In patients with PPI, NR and PR lesions are some frequently observed, and PR lesions have a greater wall area and plaque burden than NR lesions.

Objective:To investigate the application of the Addenbrooke's cognitive examination-revised(ACE-R) to the assessment of global cognition in Parkinson's disease(PD). Methods:Twenty-four PD patients were included. Their cognitive functions were assessed according to the ACE-R scales. Results:Compared with 11 cases of abnormal MMSE scores and 13 cases of normal MMSE scores in 24 cases of PD patients,the age was significantly different in 2 groups with MMSE(P < 0.05),but the duration of symptoms,Hoehn-Yahr stage and UPDRS-motor were not significantly different. Compared with 14 cases of abnormal ACE-R scores and 10 cases of normal ACE-R scores in 24 cases of PD patients,the duration of symptoms,Hoehn-Yahr stage and UPDRS-motor were significantly different in 2 groups with ACE-R(P < 0.05),but the age was not significantly different. The scores of five cognitive subdomains in ACE-R(attention and concentration,memory,verbal fluency,language and visuospatial) in 2 groups with ACE-R were significantly different(P < 0.005). Conclusion:The ACE-R has higher sensitivity than the MMSE for cognitive assessment in PD patients. The ACE-R is more suitable than the MMSE as a cognitive screening tool for PD patients.

Objective To study the value of susceptibility weighted imaging(SWI)in etiological diagnosis of cerebral hemorrhage due to amyloid cerebral disease.Methods 128patients with head CT-confirmed cerebral hemorrhage admitted to our hospital from June 2011to December 2012,23underwent SWI scanning.Their hemorrhagic foci detected by head CT and SWI were compared.The patients were followed up for 4-18 months(mean 10.78±5.31 months)by telephone.Results Of the 23patients who underwent SWI scanningm,9(39.13%)met the Boston cerebrovascular disease diagnosis criteria.Head CT showed 10hemorrhagic foci but no cerebral microbleeding(CMB).Ninety-five CMB were detected by SWI,which were much more than those detected by head CT.The condition of the patients was stable except 1who lost the follow-up,1who died of recurrent cerebral hemorrhage,and 1whose condition was excerbated.Conclusion The sensitivity of SWI is significantly higher than that of head CT in detecting CMB,thus contributing to the early diagnosis of cerebral hemorrhage due to amyloid cerebral disease.

<正>横贯性脊髓炎(TM)是脊髓的炎性损害,年发病率为百万分之一(重症)到百万分之八(轻症)。TM常有脊髓磁共振信号的异常和(或)脑脊液细胞的增多。在2002年专家共识已提出典型TM的诊断/排除标准(表1):累及脊髓多个节段,但并不是影像学或病理学的横贯性损害,仍保留"横贯性"是因为脊髓感觉传导通路损害平面对定位诊断的意义。本指南旨在回答下述临