多发性硬化影像学诊断价值

The Diagnostic Value of Imaging about Multiple Sclerosis

多发性硬化(multiple sclerosis,MS)是最常见的中枢神经系统白质脱髓鞘疾病,以病灶多发、病程缓解与复发交替为特征。CT显示MS斑的阳性率仅为MRI的54.6%,在小脑、脑干及胼胝体上更低。MRI对MS诊断的敏感性比CT高,很多CT阴性者常能在MRI上显示病灶,特别是对后颅窝和脊髓病灶,MRI更优于CT。常规MRI技术检查局部白质病灶有极高的灵敏度,新的定量MRI技术对正常脑白质轻微改变的灵敏度增高以及对MS不均一性的病理学变化特异性增加。磁化传递成像、弥散加权成像、弥散张量成像(MTI、DWI、DTI)细胞特异性成像能够提供关于T2可见病灶内外细胞和结构改变的信息。常规和新的MRI技术的广泛应用将会提高对MS的诊断。

Multiple sclerosis（MS） is the commonest demyelinating diseases of the central nervous system,which the characteristics are multiple lesion,and alternating course with relief and relapse.The positive rate of CT that show plaques in multiple sclerosis is only 54.6% as compare with MR,that is lower on cerebellum,brainstem and corpus callosum.The sensitivity of MRI is better than CT to diagnose MS,many CT negative change demonstrates the lesions on MRI,specially on posterior cranial fossa and spinal cord lesions.The conventional MRI has extremely high sensitivity to inspect partial white matter lesions.With new quantitative MRI technology,the sensitivity to slight change of normal brain white matter and specificity to inhomogenous pathology change of MS has increased.MTI,DWI,DTI and cell specificity image formation can provide the information of T2 obvious lesions inside and outside the cell and the structural change.The widespread application of conventional and new MRI technology will improve the diagnosis of MS.