脊髓多发性硬化的MRI诊断

MRI Diagnosis of Multiple Sclerosis in Spinal Cord

目的 提高对脊髓多发性硬化的MRI诊断水平。材料与方法 对 14例脊髓多发性硬化病变的部位、范围、病变处脊髓形态、MR信号及强化程度进行分析评价。结果 脊髓多发性硬化的特征性MRI表现为 :主要发生在颈段脊髓 ,病变平均为 5个椎体长度 ,急性期病变局部脊髓肿胀 ,病变呈斑片状 ,T1WI呈低或等信号 ,T2 WI呈高信号 ,静脉注射Gd DTPA后病变呈斑片状或边缘强化。经激素正规治疗后病变脊髓恢复正常 ,强化程度减弱或无强化。结论 MRI不仅有助于脊髓多发性硬化的诊断 ,而且有助于与其他脊髓内病变的鉴别诊断。

Objective To improve the clinical diagnosis of spinal multiple sclerosis (MS).Materials and Methods MRI findings in 14 cases with MS, including the location, extent and shape of the spinal lesions, as well as the signal and enhancement of the lesions, were analyzed.Results On MRI, spinal MS showed some characteristics. (1) The lesion mainly developed in cervical cord. (2) The average length of the lesion usually covered five vertebral bodies. (3) The diseased cord was swollen in acute stage. (4) The lesions were manifested as patches in shape with low or iso signal intensity on T 1WI and high signal intensity on T 2WI, showing patchy or marginal enhancement after intravenously administration of Gd DTPA. (5) After the patient was treated with standard hormonotherapy, the diseased cord returned normal with weakened, or without, enhancement.Conclusion MRI is helpful not only in the diagnosis of spinal MS, but also in the differentiation with other spinal lesions.