视神经脊髓炎脑部异常的MRI表现及相关危险因素分析

目的 分析视神经脊髓炎(NMO)脑部异常的MRI表现及特征,探讨脑内病灶发生的相关危险因素.方法 对符合2006年Wingerchuk诊断标准的54例NMO患者行脑部MR检查,分析脑部MRI异常患者病灶的分布及信号特点.采用Logistic回归分析评估脑内病灶发生的相关危险因素.结果 54例NMO患者脑部MRI正常24例(44.4%),MRI表现异常30例(55.6%),以多发的皮层下和皮髓质交界区白质小病灶最常见(13/30,43.3%).典型的NMO脑内病灶位于胼胝体、脑室室管膜下、下丘脑及脑干等部位,表现为斑点、斑片及线状异常信号.16例脑部增强检查均未见异常强化病灶.Logistic回归分析显示病程以及合并自身免疫病或前驱感染史与脑部MRI异常有关联(OR=3.519,P＜0.05).结论 NMO患者脑部MRI出现异常信号较常见并有较特异的好发部位.合并系统性自身免疫病或有前驱感染史的NMO患者容易出现脑部MRI异常.

Abstract：

Objective To investigate the MRI features of the brain in patients with neuromyelitis optica (NMO), and to evaluate the correlation between the brain abnormalities and related risk factors.Methods Fifty-four patients with definite NMO according to 2006 Wingerchuk diagnosis criteria were enrolled in this study. MRI scanning of the brain was performed in these patients. Distribution and signalfeatures of all the lesions were analyzed. A Logistic regression analysis was used to evaluate the risk factors of brain abnormalities. Results Twenty-four NMO patients (44. 4%) showed unremarkable findings and thirty (55.6%) showed abnormalities on brain MRI. Multiple and non-specific small lesions in the subcortical white matter and grey-white matter junction were the most frequent abnormalities on brain MRI (13/30, 43. 3%). Typical lesion locations included corpus callosum, subependyma of ventricles,hypothalamus and brain stem. The lesions showed punctate, patchy and linear abnormal signals. Postcontrast MRI showed no abnormal enhancement in 16 cases. Logistic regression analysis showed that coexisting anto-immune disease or infection history had correlations with abnormalities of the brain on MRI (OR=3.519,P ＜0.05). Conclusions There was a high incidence of brain abnormalities in NMO.Subependymal white matter, corpus callosum, hypothalamus and brain stem were often involved in NMO.NMO patients with coexisting anto-immune disease and infection history had higher risk of brain abnormalities.

MRI abnormalities and related risk factors of the brain in patients with neuromyelitis optica

Objective To investigate the MRI features of the brain in patients with neuromyelitis optica (NMO), and to evaluate the correlation between the brain abnormalities and related risk factors.Methods Fifty-four patients with definite NMO according to 2006 Wingerchuk diagnosis criteria were enrolled in this study. MRI scanning of the brain was performed in these patients. Distribution and signalfeatures of all the lesions were analyzed. A Logistic regression analysis was used to evaluate the risk factors of brain abnormalities. Results Twenty-four NMO patients (44. 4%) showed unremarkable findings and thirty (55.6%) showed abnormalities on brain MRI. Multiple and non-specific small lesions in the subcortical white matter and grey-white matter junction were the most frequent abnormalities on brain MRI (13/30, 43. 3%). Typical lesion locations included corpus callosum, subependyma of ventricles,hypothalamus and brain stem. The lesions showed punctate, patchy and linear abnormal signals. Postcontrast MRI showed no abnormal enhancement in 16 cases. Logistic regression analysis showed that coexisting anto-immune disease or infection history had correlations with abnormalities of the brain on MRI (OR=3.519,P ＜0.05). Conclusions There was a high incidence of brain abnormalities in NMO.Subependymal white matter, corpus callosum, hypothalamus and brain stem were often involved in NMO.NMO patients with coexisting anto-immune disease and infection history had higher risk of brain abnormalities.