脑多发性硬化病灶和脑萎缩的MRI特点及其相关因素的研究

目的 探讨脑多发性硬化(MS)病灶和脑萎缩的MRI特点,并对其与脑萎缩的关系及其相关因素进行分析.方法 80例确诊的脑MS患者按照年龄分成两组;每例患者MRI检查时均进行5 mm层厚不间断横断面T1、T2加权像扫描;观察MS的病灶数目、信号和形态特点及分布规律;测量脑萎缩数据,并与正常对照组进行比较;对MS脑萎缩的相关因素进行分析.结果 (1)MRI显示脑MS病灶多呈卵圆形或类圆形,边界较清楚,典型病灶长轴与侧脑室切线垂直,病灶以等或稍长T1、长T2信号改变为主.(2)与健康对照组比较,脑MS患者脑室的测量径线明显增大,脑沟及外侧裂明显增宽,脑实质的测量径线明显缩小.(3)对MS患者脑萎缩的相关因素进行分析得出扩展残疾状态评分(EDSS)是脑萎缩的最主要预测因素.结论 脑MS的病灶多分布在侧脑室周围,以等或稍长T1、长T2信号为主,病灶形态多呈卵圆形或类圆形,边界较清楚;脑MS患者的病程、病灶的数目及直径以及EDSS得分均与脑萎缩明显相关;脑萎缩在脑MS患者中普遍存在并逐渐进展,其测量数据可作为临床监测MS进展的一个有用指标.

Study of MRI features in the lession and brain atroplny of cerebral multiple sclerosis and its correlated factors

Objective To study MRI feature in the lession and brain atrophy of cerebral multiple sclerosis (MS), and to analyze the relationship and the its correlated factors between cerebral MS and brain atrophy. Methods The MRI data from 80 patients with cerebral MS were collected and these patients were divided into two groups according to age. Each patient received T1-weighted and T2-weighted scanning. The number of lesion, characteristics of lesion and brain atrophy were evaluated and compared with control group. The correlated factors of brain atrophy were analyzed. Results (1)The most focal demyelinating lesions of cerebral MS were orbicular-ovate or similar round like with distinct boundary. Typical lesions presented with equal or long T1 and long T2 signals. The macroaxis of lesion was vertical to tangent line of lateral cerebral ventricle. (2)Compared with control group, the cerebroventricular anfractuosity was longer and lateral fissure was wider on MRI in cerebral MS group. The diameter of brain parenchyma was shorter. Statistic differences were found between two groups. (3)Among correlated factors, EDSS was the main predictive factor for cerebral atrophy. Conclusions The most lesions of cerebral MS are mainly located around lateral cerebral ventricles, orbicular-ovate or similar round like with distinct boundary, equal or slight long T1 and T2 signals on MRI.Brain atrophy is generally in cerebral MS and progress gradually, it is related to the course of disease, the number of lesion, the diameter of lesion and EDSS score. Measurement of brain atrophy may regard as an index about progression of MS.