初回 MRI で偽陰性だった脳幹・小脳梗塞症例の検討  [in Japanese] A Study of Cases of Brainstem/cerebellar Infarction Detected as False Negatives by Initial MRI  [in Japanese]

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Author(s)

    • 假谷 伸 Kariya Shin
    • 岡山大学大学院医歯薬学総合研究科耳鼻咽喉・頭頸部外科学 Department of Otorhinolaryngology, Okayama University Graduate School of Medicine
    • 岡 愛子 Oka Aiko
    • 香川労災病院耳鼻咽喉科・頭頸部外科 Department of Otorhinolaryngology, Kagawa Rosai Hospital
    • 津村 宗近 Tsumura Munetika
    • 岡山大学大学院医歯薬学総合研究科耳鼻咽喉・頭頸部外科学 Department of Otorhinolaryngology, Okayama University Graduate School of Medicine
    • 平田 裕二 Hirata Yuji
    • 香川県立中央病院耳鼻咽喉科・頭頸部外科 Department of Otorhinolaryngology, Kagawa Prefectual Central Hospital
    • 西﨑 和則 Nishizaki Kazunori
    • 岡山大学大学院医歯薬学総合研究科耳鼻咽喉・頭頸部外科学 Department of Otorhinolaryngology, Okayama University Graduate School of Medicine

Abstract

<p> 脳幹・小脳梗塞は耳鼻咽喉科に関連するさまざまな脳神経障害を来すことが知られている. 急性期脳梗塞は早期治療を目的に MRI の拡散強調像 (DWI) で評価されるが, 急性期の場合は DWI が偽陰性になることがあり脳神経障害の精査のため耳鼻咽喉科を受診することがある. 香川労災病院に脳幹・小脳梗塞のため入院した245人250例を対象とし, 初回 DWI で偽陰性だった脳幹・小脳梗塞の16症例について検討した. 初回 DWI 偽陰性は脳幹梗塞12例, 小脳梗塞3例, 脳幹・小脳梗塞1例であった. 16例全例が12時間以内に初回 DWI 撮影をされていた. 250例中めまいや嚥下障害の精査目的で耳鼻咽喉科を受診し脳幹・小脳梗塞と診断された耳鼻咽喉科診断例は8例あり, そのうち3例が初回 DWI偽陰性であった. 初回 DWI で梗塞像がないが脳梗塞が疑われる場合は定期的な神経診察や DWI 再検をする必要がある.</p>

<p> Brainstem/cerebellar infarction is known to cause various cranial nerve symptoms that may require otorhinolaryngological evaluation. Acute-phase cerebellar infarction is evaluated by MRI with diffusion-weighted imaging (MRI-DWI). However, in the acute phase, MRI-DWI may show false-negative results, because of which patients are referred to the department of otolaryngology for further evaluation of the cranial nerve symptoms. We investigated 250 cases of brainstem/cerebellar infarction in 245 patients who were admitted to our hospital between 2010 and 2015. Of the 250 cases, eight cases were diagnosed at the department of otolaryngology after detailed evaluators for dizziness or dysphagia, and three of them were false negative on initial MRI-DWI. In total, we examined 16 cases detected as false negatives upon initial MRI-DWI. Of the 16 cases, 12 were brainstem infarctions, three were cerebellar infarctions, and one was infarction of the brainstem and cerebellum. All 16 cases were evaluated by initial MRI-DWI within 12 h of onset. Careful observation of the neurological findings and follow-up MRI-DWI are useful for the detailed evaluation of patients suspected to have a cerebellar infarction.</p>

Journal

  • Nippon Jibiinkoka Gakkai Kaiho

    Nippon Jibiinkoka Gakkai Kaiho 119(10), 1290-1299, 2016

    The Oto-Rhino-Laryngological Society of Japan, Inc.

Codes

  • NII Article ID (NAID)
    130005281949
  • NII NACSIS-CAT ID (NCID)
    AN00191551
  • Text Lang
    JPN
  • ISSN
    0030-6622
  • NDL Article ID
    027727445
  • NDL Call No.
    Z19-250
  • Data Source
    NDL  J-STAGE 
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