视神经脊髓炎脊髓磁共振成像特征

Magnetic resonance imaging appearance of neuromyelitis optiea in spinal cord

目的比较视神经脊髓炎（NMO）与多发性硬化（MS）的脊髓MRI特点，从MRI的角度重新认识NMO。方法对20例MS患者和23例NMO患者的脊髓MRI进行回顾性分析。结果NMO患者脊髓MRI多表现为线样延髓征、线样延髓脊髓征、线样脊髓征、脊髓横贯性或次横贯性损伤，且常超过3个节段（23例），而MS患者脊髓MRI病变节段短（≥3个节段者8例.Х^2=19．142，P〈0．01），常呈偏心性分布（17例，与NMO组比较，Х^2=25．256，P〈0．01）。结论NMO不同于MS，在MRI方面，病灶的分布有其自身特征，而MS的脊髓病灶与髓鞘走向一致。因此，我们从影像学角度进一步证实NMO是有异于MS的一种独立的疾病。

Objective To investigate the characteristic MRI appearance of neuromyelitis optica （NMO） and multiple sclerosis （MS） in the spinal cord. Methods Twenty cases of MS and 23 cases of NMO were examined by MRI. All image appearances were analyzed. Results The characteristic MRI appearance of NMO patients in the spinal cord was linear medullary lesion （ LML）, linear medullospinal lesion （LMSL）, linear spinal lesion （LSL） and longitudinally extensive transverse myelitis （LETM）, and spinal cord MRI with contiguous T2-weighted signal abnormality extending over 3 or more vertebral segments （23 cases）, while in MS, spinal cord MRI with contiguous T2-weighted signal abnormality often extended less than 3 vertebral segments （only 12 cases, Х^2 = 19. 142, P 〈 0. 01 ）, and the distribution of spinal lesion usually was eccentric （ 17 cases, compared with NMO group, Х^2 = 25. 256, P 〈 0. 01 ）. Conclusions NMO is distinct from MS. In MRI, spinal lesion in NMO usually conforms to the distribution of aquaporin 4, while spinal lesion in MS always conforms to the demyelination. NMO has neuroimaging features that move it ever closer to distinct disease status.