目的分析非酮症高血糖偏侧舞 蹈症的临床表现及脑部CT和MRI的影像学 特点，旨在提高对本病的认识，避免误 诊、漏诊。方法 回顾性分析兴宁市人民 医院2016年3月至2018年2月期间经临床确 诊的6例非酮症高血糖偏侧舞蹈症患者的 临床资料及CT和MRI影像学表现。6例患者 均行头颅CT平扫、MRI平扫和增强，6例 行MRI扫描患者均加做了DWI序列，3例加 做SWI序列扫描。3例行CT平扫复查。观察 分析病变部位、大小、形态、密度/信号 特征及强化程度。结果 6例患者，男性2 例，女性4例。6例患者发病时临床均表现 为单侧肢体或面部不自主、无规则的舞蹈 样动作。发病时血糖 22.56-33.42mmol/ L。尿酮均为阴性。6例患者CT扫描可见患 侧肢体对侧基底节区尾状核头部或豆状核 片状高密度影。MRI表现为相应的基底节 区尾状核头部或豆状核片状T1WI呈高信 号。T2WI呈低信号为主。FLAIR呈低信号 为主。DWI呈低信号，其中2例为稍高或稍 低信号。SWI呈低信号或者等低信号。增 强扫描后病灶呈轻度或者明显均匀强化。 经降糖等治疗后，患者临床症状均有不 同程度缓解，影像学表现也有变化，1例 经治疗5小时后复查CT，病灶高密度影消 失。其余2例经治疗半个月、1个月后CT复 查示病灶范围较前缩小，密度较前减低。 结论 非酮症高血糖偏侧舞蹈症脑部CT和 MRI有非常典型的影像学表现，再结合病 史和临床症状、体征，能及时做出准确诊 断，避免误诊、漏诊。

Objective To analyze the clinical manifestations and brain CT and MRI imaging features of non-ketotic hyperglycemia hemichorea, aiming to improve the understanding of the disease and avoid misdiagnosis and missed diagnosis. Methods Clinical data and CT and MRI imaging findings of 6 patients with clinically-proved non-ketotic hyperglycemia hemichorea from March 2016 to February 2018 in Xingning People's Hospital were analyzed retrospectively. Six patients underwent unenhanced CT scan, unenhanced MRI scan and enhancement, and DWI sequence(6), SWI sequence scan(3), follow-up unenhanced CT scan(3). Location, size, morphology, density/signal characteristics and degree of enhancement of the lesion were observed and analyzed. Results Six patients included 2 males and 4 females. Six patients showed clinical manifestations of unilateral limb or facial involuntary, irregular dance-like movements. Blood glucose was 22.56- 33.42 mmol/L at the onset. Urine ketones were all normal. Patchy hyperdense lesion in the caudate nucleus or lenticular nucleus in the contralateral basal ganglia of the affected limb were seen on CT and T1WI of 6 patients, while low signals on T2WI and FLAIR. DWI showed a low signal, of which 2 cases showed slightly higher or lower signals. SWI is hypo or isointense. The lesions showed mild or marked enhancement. After treatment with hypoglycemic and other treatments, the clinical symptoms of the patients were alleviated to varying degrees, and the imaging findings were also changed. One case was reexamined after 5 hours of treatment, and the lesions disappeared. The remaining 2 cases were treated for half a month and 1 month , follow-up CT scan showed that the lesion range was smaller than before and the density was lower than before. Conclusion Nonketotic hyperglycemia hemichorea cerebral CT and MRI have typical imaging findings, combined with medical history and clinical symptoms and signs, can make accurate diagnosis in time to avoid misdiagnosis and missed diagnosis.