多发性硬化增强磁共振成像与甲基强的松龙治疗的相关性研究

Study Of Treat Methylprednisolone And Magnetic Resonance Imaging To Multiple Sclerosis

目的探讨多发性硬化(MS)中增强磁共振成像(MRI)与甲基强的松龙治疗的相关性。方法选择确诊MS60例,检查增强MRI及平扫,并常规给予大剂量甲基强的松龙冲击治疗,每4～8w复查1次增强MRI及平扫,观察病灶的形态变化及临床表现情况。结果60例MRI增强病灶中,约69.15%在治疗后的4w内消失,93.3%于8w内消失,其余增强病灶明显弱化,病灶强化程度的变化与临床呈正相关。而病灶未强化者治疗前后相差不大。结论MS增强MR灶阳性者绝大多数对激素治疗敏感,而增强MR灶阴性者对激素治疗不敏感,可考虑使用免疫抑制剂或干扰素。

Objective To investigate the correlation between enhanced brain magnetic resonance imaging （MRI） and the effectsofmethylprednisolone in patients with multiple sclerosis （MS） . Methods 60 patients with clinically definite multiple sclerosis were checked brain enhanced MRI and plain MRI scan before administered high-dose methylprednisolone（1000 mg/d）, after that they were checked every 4-8weeks.The changes of MRi lesions and clinical manifestations were analyzed. Results Of the enhanced MRI lesions in 60 patients 69.15% lasted less than 4 weeks after the treatment, 93.3% 8 weeks and others weakening obviously. The enhancement degree of the lesion on MRI carries a positive correlation with the clinical effects of treatment ,while the nonenhanced lesions on MRI had little difference pre and post treatment .Conclusions Most of the MRI enhanced positive MS patients were sensitive to the glucocorticois, whereas negative patients were resistant to it and could be use immunosuppressive agents or interferon.