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運動ニューロン疾患の錐体路変性に関する頭部Magnetic Resonance Imagingおよび神経病理学的検討 Degeneration of the pyramidal tracts in motor neuron disease (MND) examined by cranial MRI and neuropathological analysis 三井, 良之 Mitsui, Yoshiyuki 近畿大学 Kinki University motor neuron disease (MND) magnetic resonance imaging (MRI) pyramidal tract myelinated fibers axonal loss The degeneration of the intracranial pyramidal tracts in the patients with motor neuron disease (MND) was studied using magnetic resonance imaging (MRI) and neuropathological analysis. Nineteen patients with MND and 51 normal subjects were examined using cranial MRI. In the patients group, twelve had only lower motor neuron sign (SPMA type) and seven had both upper and lower motor neuron signs (ALS type). Of the normal subjects, 24 (47%) had prolonged small areas (high signal intensity areas) localized to the posterior internal capsule on T2 images. High signal intensity areas at the posterior internal capsule were revealed in 12 MND patients. In 8 of these 12 patients, high signal intensity areas extended from the crus cerebri to corona radiata. These findings were found in 6 of 7 patients with ALS type and in 2 of 12 patients with SPMA type. Meanwhile, three patients were autopsied and studied neuropathologically. Two of these patients had high signal intensity areas along the pyramidal tracts in T2 weighted images. In these two patients, myelin pallor and axonal loss were detected by Klüver-Barrera and Bodian stains. Moreover, in these two cases, the decrease of the number of myelinated fibers in the internal capsule was revealed by toluidine blue stain. In the other patient who did not have a high signal area, myelin pallor and axonal loss were not clear. These results warrant the conclusion as follows ; ① high signal intensity areas in T2 weighted images are localized at the posterior internal capsule in the normal subjects. ② cranial MRI can detect abnormalities of the pyramidal tracts in MND patients from internal capsule to crus cerebri and corona radiata. ③ high signal intensity areas in T2 weighted images mainly reflects a loss of axons and myelin pallor in neuropathological analysis of the autopsied cases. ④ cranial MRI is useful for detecting of the abnormalities in the pyramidal tracts at the internal capsule level in patients with MND. 本文データはCiNiiから複製したものである。 近畿大学医学会 1993-12-25 jpn departmental bulletin paper AM https://kindai.repo.nii.ac.jp/records/2002045 03858367 近畿大学医学雑誌 Medical Journal of Kinki University 18 4 533 546 https://kindai.repo.nii.ac.jp/record/2002045/files/AN00063584-19931225-0533.pdf application/pdf 1.1 MB