重庆地区多发性硬化临床和影像特征分析

Analysis of the clinical and images characteristics in patients with multiple sclerosis

目的:探讨多发性硬化(Multiple sclerosis,MS)的临床和影像学表现。材料与方法:收集资料完整符合McDonald诊断标准的180例MS患者作为研究对象,按照国际MS中心制定的扫描序列进行扫描,分析MS主要临床特点、脑和脊髓病灶影像特点以及与临床残疾状态功能评分(Expanded disability status scale,EDSS)的相关性。结果:(1)本组MS患者以上呼吸道感染为主要诱因之一(27.78%),以肢体无力为最常见的症状(54.4%)。(2)按照病灶受累的部位分类:单纯脑部受累45.56%,单纯脊髓受累29.44%,脑和脊髓均受累25%,三者之间的EDSS评分有统计学差别(P<0.05)。(3)下颈髓和上胸髓最易受累,≤3个节段的病灶数占74.49%,累及1～2个节段脊髓病灶例数最多。结论:结合临床和MRI影像特征,有利于MS的诊断和监测病灶的发展。

Objective：To identify clinical and MRI images characteristics in patients with multiple sclerosis （MS）. Methods： 180 patients who fulfilled the MS diagnostic criteria of McDonald were selected to undergo MRI scans of the brain and spinal cord. The clinical characteristics and the MRI images of the brain and spinal cord were analyzed. The patient＇s neurological disability was assessed using the Kurtzke expanded disability states scale （EDSS） scores. Results ： （ 1 ）The one of the main motivations is the upper respiratory tract infection（27.78% ）, and the most frequent onset symptom was weakness in one or more limbs （54.4%）. （2）The patients with simple brain lesions were involved in 45.56% ,followed by the spinal cords （29.44%）,and both brain and spinal cord involvement in 25%. The EDSS scores were statistical differences among the patients with the simple brain involvement, simple spinal cord involvement, both brain and spinal cord involvements （P〈 0.05 ）. （3）The lower cervical and upper thoracic spinal cords were easily involved, the length of cord lesions which were less than three vertebral segments was 74.49% ,the 1 - 2 segments were the most frequent involved. Conclusion： The combination of clinical characteristics and conventional MRI can improve the diagnosis and monitor the progressive for patients with MS.