急性播散性脑脊髓炎的临床和MRI表现

目的研究急性播散性脑脊髓炎(ADEM)的临床特点及MR I表现,以期提高对该病的诊断水平。方法回顾性分析6例符合临床标准的ADEM患者的临床特点及MR I表现。6例患者均行头颅及颈、胸髓MR扫描,3例头颅平扫后行增强扫描。结果(1)临床表现:6例患者均有前驱病史或疫苗接种史,神经系统症状多样;(2)MR表现:6例共发现病灶42个,病灶多发且不对称,主要累及皮层、皮层下及侧脑室周围脑白质,也可累及脑灰质,病变呈大小不等的片状或点状异常信号,部分病灶可见“垂直征”。结论ADEM的临床表现有一定的特点,MR I表现有一定的特征性并能为ADEM的临床提供重要的诊断信息。MR I表现结合病史及单时相病程可对ADEM作出早期诊断。

Acute disseminated encephalomyelitis: clinical and MRI features

Objective To identify the clinical features and the MRI manifestations of ADEM and to improve the skill of diagnosis.Methods The clinical features and the MRI manifestations of 6 cases of ADEM were reviewed retroretrospectively spectively.MRI scanning of the brain and the spinal cord were performed in all cases in acute stage.3 cases were enhanced scanned after Gd-DTPA.Results(1)Clinical manifestations:the prodromal infection and vaccination were found in 6 cases.Various symptoms of central nervous system occurred one by one or simultaneously in illness process.(2)MR manifestations:A total of 42 lesions were present in 6 cases.Multiple and asymmetrical lesions were revealed in the cortex,subcortical and periventricular white matter.Some lesions were revealed in thalami,brainstem,cerebellum and the gray matter.Patchy or punctuate abnormal signal intensities with various size werc demonstrated in all patients.The pattern of perpendiculatr distribution against the lateral ventricles were detected in 4 cases.Conclusions ADEM has some features on clinical presentation and has some characteristics on MRI manifestations.MRI can provide important information for clinical diagnosis of ADEM.Early diagnosis of ADEM could be made by MRI manifestations of the brain and the spinal cord combined with the history and monophasic clinical setting.