视神经炎的磁共振成像与视觉诱发电位的对比研究

目的探讨诊断视神经炎的有效MRI检查序列以及MRI与VEP的相关性。设计回顾性病例系列。研究对象55例(110眼)出院诊断视神经炎、视神经乳头炎、多发性硬化、视神经脊髓炎的视力下降患者。方法对上述患者行常规颅脑MRI、视神经STIR和Gd-DTPA增强扫描联合脂肪抑制技术,分析MRI图像,对MRI和VEP结果与临床视力表现的一致性进行分析;对MRI与VEP的一致性进行分析。主要指标视力,MRI视神经信号、形态、强化,视觉诱发电位P_(100)潜伏期。结果视力与MRI之间的一致性为81.81%,Kappa(κ)值为0.500。视力与VEP之间的一致性为86.32%,κ=0.581。MRI表现与VEP结果之间存在一定的一致性,κ=0.378。结论MRI脂肪抑制技术和Gd-DTPA增强扫描联合脂肪抑制技术有助于视神经炎定位和定性诊断,VEP有助于视神经炎的诊断和亚临床病灶发现。MRI结合VEP能提高诊断的准确率。(眼科,2007,16:319-322)

Comparison study of MRI and visual evoked potential (VEP) in optic neuritis

Objective To investigate the effective MRI sequence in diagnosing optic neuritis and the relationship between MRI and VEP.Design Retrospective case series.Participants Fifty-five patients of optic neuritis,papillitis,multiple sclerosis and Devic's disease with visual loss.Methods Conventional brain MRI,STIR and Gd-DTPA enhancement combined with fat suppression technique were performed on the 55 eases.Clinical characteristics,MRI findings,VEP were analyzed and the consistencies compared with the results.Main Outcome Measures Vision,optic nerve signal,modality and enhancement on MRI,latency of wave P_(100)in VEP.Re- sults Between clinical visual symptoms and optic nerve MRI signals,VEP results,the Kappa values were 0.500 and 0.581 respectively, and the consistency between them were statistical significantly.Optical nerve MRI signals and VEP results have consistency,the Kappa value between them was 0.378. Conclusions MRI,STIR and Gd-DTPA enhancement combined with fat suppression technique are useful in diagnosis of optic neuritis.VEP is helpful in diagnosis of optic neuritis and in finding silence focus.The combined use with MRI and VEP will improve the diagnostic accuracy of optic neuritis.(Ophthalmol CHN,2007,16:319-322)