急性播散性脑脊髓炎MRI表现

目的描述急性播散性脑脊髓炎的脑部MRI表现及临床特点。探讨MRI对本病的诊断价值。方法符合临床诊断标准的急性播散性脑脊髓炎患者21例，18例发病前有病毒感染或疫苗接种史。全部病例行头部MRI检查，18例行MRI复查。结果病变多发，不对称，大脑白质受累2l例，16例同时累及丘脑，13例可见“垂直征”，19例异常增强，15例复查见异常信号缩小且数目减少。结论急性播散性脑脊髓炎均有脑部MRI改变且颇具特征性。结合病史及厦单相病程可作出早期诊断，MRI随诊是评价疗效的重要手段，MRI显示丘脑受罪可作为鉴别本病与多发性硬化的主要依据。

Clinical and Brain MRI Study of Acute Disseminated Encephalomyelitis

Objective To describe the MRI findings of the brain in acute disseminated encephalomyelitis(ADEM) and its clinical features and to evaluate the usefulness of MRI imaging in diagnosing ADEM and assessing the therapy.Methods 21 cases of clinically proven ADEM were retrospectively reviewed.18 patients had a history of viral infection or vaccination prior to the onset of ADEM.MRI scanning of the brain was performed in all cases in acute stage and follow-up MRI imaging was achieved in 18 cases.Results Multiple and asymmetrical lesions were revealed in the white matter(21 cases),thalami(16 cases).The pattern of perpendicular distribution against the lateral ventricles was detected in 13 cases.Contrast enhancement was observed in 19 cases.Follow-up MRI imaging showed that the abnormal signals decreased in both size and number in 15 cases.Conclusion Abnormal signals are in all the patients with ADEM and they have some characteristics by which early diagnosis could be made if combined with the history and monophasic clinical setting.Follow-up MRI imaging plays an important role in further confirming the diagnosis and in evaluating the therapy as well.Thalamic involvement as shown by MRI imaging proved useful in distinguishing between ADEM and multiple sclerosis.