多发硬化症的MRI诊断及其误诊原因分析(附126例报告)

目的:进一步探讨不典型病例的诊断及可能导致其误诊、漏诊的原因,以便提高我们的诊断水平。材料及方法:本组共收集了126例多发硬化症患者,其中4/5为典型病例,1/5为临床表现、体征、影像学检查均不典型,但经临床及影像学追迹得以确诊的病例。126例中男60例;女66例;年龄在11—55之间,平均36岁。除头颅MR扫描外,对脊髓病变进行了追迹检查,多数做了增强扫描。结果:病变侵犯单一部位者76人,多部位者50人。多发硬化症的MRI表现:对典型的病例,诊断多无困难;但对不典型病例,则需加以注意,其中包括发病部位、病变形态,大小,周围水肿之有无,强化表现等。结论:不典型的多发硬化症MRI表现是造成误诊、漏诊的主要原因。

MRI Diagnosis of Multiple Sclerosis and Analysis for Its Misdiagnostic Causes: Results in 126 cases.

Purpose: To elevate the accuracy in the diagnosis of cerebrospinal multiple sclerosis with atypical MRI appearances and to analyze the causes that probably lead to the misdiagnosis or leaky diagnosis. Materials and Methods: The authors summarized and analyzed the diagnostic results in 126 patients in whom male and female were 60 and 66 cases, respectively, the age ranged between 11 to 55 years with a mean age of 36 years. In the case of clinic manifestations, symptoms, and imaging examinations in 126 patients, four fifth of them were typical patients but another one fifth who have been accurately diagnosed by the follow -up survey of clinic or imaging were atypical patients. Both skull and spinal lesion in all patients have been observed by MR scanning and in the most patients the enhanced scanning have been performed. Results: For the invasive position of the lesion, the single position was found in 76 patients and the multiple position were found in 50 patients. In general, MRI diagnosis of multiple sclerosis is not difficult for typical patients, but for atypical patients it should also overall survey the pathogenic position, focal form, size, and companing with or without the edema around the lesion and the enhanced findings. Conclusion: The atypical appearances of MRI in the diagnosis of multiple sclerosis are the principal causes leading to the misdiagnosis or leaky diagnosis.