脊髓型多发性硬化的临床与MRI的研究

目的探讨脊髓型多发性硬化(spinal cord formof multiple sclerosis,SMS)的临床和MRI特点及其诊断意义。方法对17例SMS的临床特点和磁共振(MRI)结果进行回顾性分析。结果SMS呈急性或亚急性起病,表现为复发—缓解或慢性进展病程,病灶分布上以颈髓受累最多,MRI特点为髓内散在的长T1、长T2斑块状病灶,其长度一般小于2个椎体的长度,位于脊髓的后外侧,面积小于脊髓横截面的1/2。应用糖皮质激素试验性冶疗对脊髓出现的可疑脱髓鞘病灶者诊断有一定帮助。结论诊断SMS主要依据其临床表现,MRI有助于发现病灶,明确病灶位置,是目前诊断SMS最敏感的影像学方法。

Clinical and MRI study in the spinal cord form of multiple sclerosis

Objective To study the clinical and MRI characteristics of spinal cord form of multiple sclerosis (SMS) and assess their significance for the diagnosis.Methods Seventeen cases diagnosed clinically as SMS were examined by MRI. A retrospective analysis was conducted for their clinical and MRI characteristics.Results The patients of SMS were most seen in middle aged females, with acute of subacute onest and developed with remissions/relapses and / or chronic progression. MRI showed that upper and middle segments of cervical and thoracic spinal cord were exclusively involved, most of the relapsing damages have predilection for the original lesions. Intra-spinal demyelinating plaques had hypo/isointensity on T1WI and hyperintensity on T2WI. The majority of the plaques were two vertebral body sements in length or less and posteriolaterally located, and occupied less than 50% of the cross-sectional area of the spinal cord. The effect of glucocorticoids might also be of help for the suspected cases.Conclusion The diagnosis of SMS rely mainly on its clinical characteristics. MRI is helpful to detect lesions and confirms the position of lesions, so it is the most important and sensitive method for diagnosing SMS.