多发性硬化MRI表现及其诊断价值

MRI manifestations and it's diagnosis value in multiple sclerosis

目的 :探讨多发性硬化 (MS)的MRI表现特征及其诊断价值。方法 :对 2 1例MS患者进行了MRI检查 ,所有病例均行Gd DTPA增强扫描。扫描序列包括 :T1WI、T2 WI、FLAIR ,6例进行了随访观察。结果 :2 1例均有MRI阳性表现 ,3例仅有脊髓病灶 ,12例仅有脑部病灶 ,6例脊髓与脑均有病灶。脑内病灶共 35 8个 ,以侧脑室旁白质区和半卵圆中心多见 ,形态大小不等 ,幕上多于幕下。胼胝体受累 6例 ,典型者病灶长轴与侧脑室体部垂直。脊髓表现为髓内长条状长T2 信号影 ,颈髓多见。 19例有不同程度的增强表现 ,病灶强化程度与病灶活动性明显相关。随访病例发现 :2例病情稳定者无强化表现并无新病灶出现 ,4例病情反复者出现新病灶并有强化表现。结论 :MRI能清楚显示脑和脊髓的MS病灶 ,并具有相对特征性的表现 ,能客观地反映病灶的活动性。

Objective:To evaluate the typical appearance and role of MRI in the multiple sclerosis (MS).Methods:21 cases firstly diagnosed MS with fully clinical data were examined by MRI including T 1WI,T 2WI and FLAIR sequences.All cases were performed Gd-DTPA enhancement.A follow-up examinaiton was done in 6 of 21 cases.Results:All cases have lesions in the spinal cord or/and brain.3 cases only have spinal cord lesions and 6 cases have lesions in the spinal cord and brain.In the brain lesions were mainly located periventricular and centrum semiovale region.The size and shape of lesions were different.The typical lession lie perpendicular to the corpus callosum.6 case were found to be invaded corpus callosum.The numberals of lesions in the supratentorial structure were found to be much more than infratentorial structure.In the spinal cord lesions were found high intensity and long ribbon shape in T 2WI.19 cases were found enhanced lesions.Follow-up study showed that new lesions and new enhanced lesions were related with patient's condition.Conclusion:MRI can clearly demonstrate the lesions of MS in the spinal cord and brain.The MRI appearance of MS is relatively specific.It can also objectively reflect the activity of lesions.