182例多发性硬化临床与MRI分析

目的提高对多发性硬化(multiple sclerosis, MS)的诊断水平.方法回顾性分析182例临床明确MS患者的临床与MRI资料.结果 MS好发于中年(平均发病年龄33.2±10.9岁)女性(68.7%),常见症状为肢体无力(74.2%)、感觉障碍(52.7%)和视力障碍(48.9%).MS病灶可单纯位于脑内(31.9%),或单纯仅位于脊髓内(31.3%),或脑与脊髓内均存在病灶(36.8%);好发部位依次为侧脑室旁(58.2%)、颈髓(52.8%)、胸髓(44.0%)、半卵圆中心(41.8%)和胼胝体(28.0%);病灶多呈斑片状;在T1加权像上可为低、稍低或等信号,在T2加权像上多为高信号;病灶多为斑片状或斑点状强化.结论结合临床与MRI表现,可提高对MS诊断的准确性.

Analysis of MRI and clinical features in 182 patients with multiple sclerosis

Objective To improve the ability of diagnosis of multiple sclerosis. Methods The clinical and MRI appearances of 182 clinically definitive MS were analyzed retrospectively, and the features of this disease were summarized. Results MS was commonly seen in middle aged (33.2±10.9 years) females (68.7%). The common symptoms included weakness in limbs (74.2%), abnormal in sense (52.7%)and dysfunction of eyesight (48.9%). The locations of MS lesions were merely in the brain (31.9%) or only in the spinal cord (31.3%) or both (36.8%). Lesions were commonly seen in the white matter around lateral ventricles (58.2%), cervical cord (52.8%), thoracic cord (44.0%), semi-oval center (41.8%), and corpus callosum (28.0%). Patchy like lesion was the most common form in MS. They were showed as low, slightly low or middle signal intensity in T1 weighted images and high signal intensity in T2 weighted images. These lesions were commonly showed patchy or punctuate enhancement after injecting Gd-DTPA. Conclusion The diagnostic accuracy of diagnosis of MS could be improved by combining clinical and MRI features.