中毒与代谢性脑病——对称性脑室周围白质受累

HeroinToxic Leukoencephalopathy（海洛因中毒性白质脑病）

·Heroin is an opioid that is mostcommonly used  as a recreational drug forits euphoric effects. This  substance isalso the most commonly abused  opioid andone of the most common drugs used  inoverdose-related deaths worldwide. Heroin is typically injected intravenously. However, it can also beinhaled. Symptoms usually  have rapidonset and last for hours·海洛因是一种阿片类药物，最常被用作娱乐药物，因为它有愉悦的作用。这种物质也是最常被滥用的阿片类药物，也是全世界与服药过量有关的死亡中最常见的药物之一。海洛因通常是静脉注射的。然而，它也可以被吸入。症状通常起病迅速，持续数小时。

·The most common acute complicationof injected heroin is stroke, typically involving the globipallidi (up to 10% of cases), which has asimilar imaging manifestation to that depicted in cases of carbon monoxidepoisoning. Nonetheless, the most dramatic acute effects occur with inhaledheroin. The freebase form is heated on aluminum foil, and the vapors areinhaled (commonly known as chasing the dragon). Toxic leukoencephalopathyrelated to this method of inhalation has a nonlinear progression and can have alatent period before onset. The disease continues to progress for up to 6months after cessation of heroin use.·注射海洛因最常见的急性并发症是中风，通常累及苍白球(高达10%的病例)，其影像学表现与一氧化碳中毒病例相似。尽管如此，最戏剧性的急性影响发生在吸入性海洛因上。游离的形式在铝箔上加热，蒸汽被吸入(俗称追龙)。与这种吸入方法相关的中毒性白质脑病具有非线性进展，在发病前可能有一段潜伏期。在停止使用海洛因后，这种疾病继续发展长达6个月。

·Heroin toxic leukoencephalopathymanifests as confluent, widespread, bilateral, symmetric white matterT2-weighted and FLAIR hyperintensities involving both the supra- andinfratentorial compartments (Fig 16).·海洛因中毒性白质脑病表现为汇合性、广泛性、双侧、对称性白质T2加权和FLAIR高信号，累及幕上和幕下间隔(图16)。