急性视神经炎的视觉诱发电位表现及与磁共振成像的对比研究

Visual evoked potential(VEP)findings and comparison study of VEP and MRI in acute optic neuritis

目的探讨急性视神经炎患者的视觉诱发电位(visual evoked potential,VEP)表现及其与磁共振成像(MRI)的对比分析。方法对40例(61只眼)诊断为急性视神经炎(包括视神经乳头炎和球后视神经炎)患者VEP资料进行分析,并与MRI结果进行对比分析。结果 40例中34例行P-VEP检查,成功获得检查结果共54只眼,其中50只眼主要表现为P100波潜伏期延迟(47只眼),振幅下降(14只眼),有4只眼记录不到典型P100波,6例(7只眼)F-VEP主要表现为P2波潜伏期延迟;头颅MRI有5例表现为单侧或双侧视神经增粗,6例表现为脑白质异常信号和/或脑白质脱髓鞘改变以及大脑皮层下缺血灶、梗死灶、软化灶、老年性脑改变。VEP检查阳性率明显高于头颅MRI。结论 VEP有助于急性视神经炎的早期诊断,VEP结合MRI能提高急性视神经炎诊断的准确率。

Objective To investigate the VEP findings in diagnosing acute optic neuritis and the relationship between VEP and MRI.Methods VEP was performed in forty patients（61 eyes） of acute optic neuritis（including papilitis and retrobulbar neuritis） and the results were analyzed compared with MRI.Results Thirty-four（54 eyes） out of 40 patients were successfully performed on P-VEP.Out of the 50 eyes,47 eyes presented the increased implicit time of P100 wave and 14 eyes presented reduced amplitudes of P100 wave.There are 5 eyes performed P-VEP not typically.Six patients（7 eyes） of F-VEP presented increased implicit time of P2 wave.Out of the 40 patients,5 patients presented thickened optic nerves,6 patients had abnormal cerebral white matter signal and ischemic lesions,infarction,malacia,age-related brain changes.Conclusion VEP is helpful in early diagnosis of acute optic neuritis.VEP combined with MRI can improve the diagnostic accuracy of acute optic neuritis.