脊髓型多发性硬化的MRI特征

MRI features of multiple sclerosis in the spinal cord

目的:分析脊髓型多发性硬化(multiple sclerosis,MS)的MRI特征,探讨MRI在脊髓型MS诊断与鉴别诊断中的价值。方法:搜集经临床证实的脊髓型MS 11例,均行MRI检查,对其临床及MRI资料进行回顾性分析。结果:11例共检出病灶27个,病灶分布于颈段脊髓和胸段脊髓。矢状面病灶形态主要表现为与脊髓长轴平行的长条状、梭形或斑片状。T1WI或T1WIR表现为低或等信号,T2WI均表现为高信号。病变区脊髓主要表现为轻-中度脊髓肿胀,增强扫描病灶无强化或呈团块状、长条状、边缘环状及斑片状强化,范围明显小于T2WI上所见。结论:脊髓型MS具有一定的MRI特征,但其在影像学诊断上仍需与急性横贯性脊髓炎、急性播散性脑脊髓炎、视神经脊髓炎鉴别。

Objective：To analyze the MRI features of multiple sclerosis（MS） in the spinal cord and to explore its value in diagnosis and differential diagnosis of MS. Methods：Eleven cases of spinal MS confirmed by clinic underwent MRI examination and the findings were analyzed retrospectively. Results：Of the 11 patients with spinal MS,27 loci were detected. The lesions were located in the cervical spinal cord and the thoracic spinal cord. On the sagittal plane images, the lesions were strip-shaped, paralleled to the long axis of spinal cord,or fusiform-shaped or mottled. All the lesions were hypo-/isointensity on T1WI or T1WIR and hyperintensity on T2WI. The diseased spinal cords were slightly to moderately swollen. On contrast-enhanced MR imaging,the lesions showed absent or strip-shaped, conglomeration-shaped,patchy and ring-like enhancement,and its size was obviously smaller than that shown on T2WI. Conclusions： The MS in the spinal cord has certain characteristic features on MR imaging,however,it is still necessary to distinguish it from acute transverse myelitis,acute disseminated encephalomyelitis and neuromyelitis optica.