MRI阴性的急性脊髓炎的临床特点分析

Analyse for characters of MRI negative acute myelitis

目的研究MRI未发现病灶的急性脊髓炎(acute myelitis,AM)的临床特点。方法观察并分析6例MRI阴性的AM患者(研究组)和25例MRI发现责任病灶的AM患者(对照组)的临床特点,所有患者符合急性横贯性脊髓炎协作组公布的AM诊断标准。结果研究组有前驱感染的比例显著高于对照组,从前驱感染到AM发病的潜伏期显著短于对照组,脊髓休克期出现的比例显著低于对照组,脊髓完全性横贯性损伤的比例显著低于对照组,治疗效果显著优于对照组,转化为多发性硬化或视神经脊髓炎的比例显著低于对照组。结论与MRI发现责任病灶的AM相比,MRI阴性的AM有其不同的临床特点,对其及时的识别和治疗具有重要的临床意义。

Objective To evaluate the clinical characters of MRI negative acute myelitis（AM）. Methods Observed and analyzed the clinical characters of 6 AM cases with negative MRI finding（studied group）and 25 AM cases with responsible foci shown by MRI（controlled group）. All the cases accorded with Transverse Myelitis consortium Working Group proposed diagnostic criteria. Results The percentage of prodromal infections in studied group was significantly higher than controlled group. The latent period between prodromal infections and AM attacks in studied group was significantly shorter than controlled group. The percentage of spinal shock in studied group was significantly higher than controlled group. compared with controlled group, the percentage of complete transverse spinal damages was significantly lower in studied group. The curative effects were significantly better and the percentage of tramsformed to multiple sclerosis or neuromyelitis optica was significantly lower in studied group compared with controlled group. Conclusion The clinical characters of MRI negative AM are different from those of responsible foci shown by MRI. Early recognition and therapy were of great importance.