多发性硬化与脑梗塞的核磁共振成像病灶特征及鉴别诊断

Characteristic of the T 2 Weighted magnetic resonance imaging lesion in multiple sclerosis and brain infarction

目的：探讨多发性硬化（ＭＳ）与脑梗塞的核磁共振成像（ＭＲＩ）病灶特征及鉴别方法。方法：分析临床确诊的ＭＳ２２８例及脑梗塞１６２例的脑部ＭＲＩ病灶的大小、数量、分布和形态。结果：在ＭＳ长轴５～１５ｍｍ的病灶为多，在脑梗塞２５ｍｍ以上的病灶占多数。ＭＳ与脑梗塞组，有４个以上病灶的例数分别为９１％、８７％，两组无差异。卵圆形病灶，边缘清晰、光滑、高信号强度均匀一致病灶，与侧脑室相连接病灶，长轴与侧脑室壁相垂直病灶、胼底体病灶，脑干及小脑病灶等项目，在ＭＳ远多于脑梗塞组。然而，长轴平行于侧脑室病灶、主要分布于大脑灰质的病灶（占全病灶面积为５０％以上），在脑梗塞多于ＭＳ，两组有极显著差异（Ｐ＜００１）。结论：４个以上长轴５～１５ｍｍ的多发性小灶性病灶，边缘清晰、光滑、信号均匀一致病灶，与侧脑室壁相垂直病灶，卵圆形病灶，胼底体、脑干、小脑病灶为ＭＳ的ＭＲＩ病灶特征；长轴平行于侧脑室的病灶及主要分布于大脑灰质的病灶为脑梗塞ＭＲＩ病灶特征。

Objective: In order to obtain characteristic of MRI lesion in MS and cerebrovascular disorders.we made up 12 MPI diagnosis standards.Methods: T 2-weighted images of 228 patients with multiple sclerosis (MS) and 162 control patients have been studied by 1 5 Tesla MRI instrument. The control patients were selected for having white matter lesions on MRI and were brain infarction. We analyzed some parameters such as size,number,distribution and characteristic of shape of the lesions.Results: ①Ovoid lesions.②The signal of diffuseness lesion is homogeneous,smooth of rim and clear of outline. ③The lesion is abutting bodies of lateral ventricles and >5mm.④The major axes of diffuseness lesion is perpendicular to the wall of lateral ventricles.⑤Lesion of carpus callosum.⑥Infratentorial lesion.⑦Lesion of brainstem center.they are a good many in MS.We observed. ⑧The major axes of lesion parallels body of leteral ventricles .⑨Basal ganglia lesion occupies > 50% of total lesion area are numerous in brain infarction ( P<0 01 ).Conclusion: From the first to the seventh which stated in results were characteristic of MRI lesions for MS.otherwise,the eighth and the ninth were characteristic of MRI lesions for brain infarction.