脊髓型多发性硬化的MRI诊断价值

目的:探讨脊髓型多发性硬化(spinal cord of multiple sclerosis,SMS)的磁共振(MRI)特征及其诊断价值。方法:对13例SMS的临床特点和MRI结果进行回顾分析。结果:SMS以青壮年女性多见,呈急性或亚急性起病,表现为复发-缓解或慢性进展病程,病灶分布上以颈髓受累最多,MRI特点为髓内散在的长T1、长T2斑块状病灶,其长度一般小于2个椎体的长度,位于脊髓的后外侧,面积小于脊髓横截面的1/2。应用糖皮质激素试验性治疗对脊髓出现的可疑脱髓鞘病灶者有一定的帮助。结论:诊断SMS主要依据其临床表现,MRI有助于发现病灶位置,是目前诊断SMS最敏感的影像学方法。

MRI diagnostic value in the spinal cord of multiple sclerosis

Objective: To evaluate MRI characteristics of the spinal cord of multiple sclerosis and its diagnostic value.Methods: Thirteen cases diagnosed clinically as SMS were examined by MRI.A retrospective analysis was conducted for their clinical and MRI characteristics. Results: The patients of SMS were most seen in young and middle aged females,with acute or subacute onset and developed with remissons-relapses and/or chronic progression.MRI showed that upper and middle segments of cervical and thoracic spinal cord were exclusively involved,most of the relapsing damages had predilection for the original lesions.Intra-spinal demyelinating plaques had hyperintensity on T1 WI and T2 WI.The majority of the plaques were two vertebral body sements in length or less and posteriolaterally located,and occupied less than 1/2 of the cross-sectional area of the spinal cord.The effect of glucocorticoids might also be of some help for the suspected cases. Conclusion: The diagnosis of SMS relies mainly on its clinical characteristics.MRI is helpful to detect lesions and confirms the position of lesions,so it is the most important and sensitive method for diagnosing SMS.