颅脑多发性硬化的临床及MRI诊断

目的 探讨多发性硬化(MS)的临床及MRJ特征,提高对多发性硬化的认识及诊断水平.方法 对20例颅脑MS患者临床资料、病灶部位、形态、MR信号及强化特点、胼胝体改变进行回顾性分析评价.结果 MS以青、中年女性稍多见,急性、亚急性起病,多以视觉障碍或肢体感觉、运动障碍为首发症状.视觉诱发电位大多数异常.MRJ检查18例发现病灶,敏感性90%(18/20).病灶以双侧侧脑室旁、额叶皮层及皮层下、半卵圆中心多发.病灶大、小不等,多数为圆形、卵圆形."直角脱髓鞘征"及"白质变脏征"是两个较为典型的征象.T1WI上表现为等、低信号,T2WI及Flair序列上表现为高信号,Flair序列显示病灶更清晰.增强扫描病灶可呈结节状强化、环状强化、弧形强化或无强化.结论 MS的临床及MRI表现具有一定特征.MRI有助于脑部MS的诊断及鉴别诊断,是诊断MS最敏感的成像方法.

Clinical and MRI diagnosis of brain multiple sclerosis

Objective To study the clinical and MRI features of multiple sclerosis and to get a better understanding and diagnosing level of brain multiple sclerosis. Methods Twenty patients of brain multiple sclerosis were evaluated retrospectively with regard to clinical data, lesion location,shapes, MR signal and enhancement patterns, as well as the changes of corpus callosum. Results Multiple sclerosis often occurred in young and middle-aged women with acute and subacute onset. The initial symptoms included visual disturbance, acrognosis or motor disturbance. The vision-evoked potential was abnormal in most patients. Lesions were found in 18 patients by MRI scanning, the sensitivity of MKI being 90% (18/20). The distribution of lesions were observed most frequently at the two sides of periventricle, cortical and juxtacortical of frontal lobe and centrum semiovale. The shape of lesions were mostly round or ovate with different sizes. Two typical manifestations of multiple sclerosis were "right-angle demyelination sign" and "dirty-appearing white matter ". The lesions showed as isointensive or hypointensive on T1WI, hyperintensive on T2WI and Flair sequences. The lesions showed as nodular enhancement, ringlike enhancement, arc enhancement or nonenhancment on T1 enhancement scanning. Conclusions MRI appearances of multiple sclerosis have some characteristics. MRI is helpful to diagnosis and differential diagnosis of multiple sclerosis, and also the most sensitive imaging method for multiple sclerosis.