血清NMO-免疫球蛋白G、MRI在视神经脊髓炎脑部瘤样脱髓鞘病诊断中的价值研究

The clinical value study of NMO-IgG and MRI in neuromyelitis optica with tumefactive demyelinating

目的通过对视神经脊髓炎脑部瘤样脱髓鞘病患者进行血清学和影像学分析,评价血清NMO-免疫球蛋白G、MRI的诊断价值。方法回顾性分析2008年5月至2013年5月来我院就诊的视神经脊髓炎脑部瘤样脱髓鞘病患者100例,分析统计其血清NMO-免疫蛋白G阳性情况、MRI图像特点。结果血清NMO-免疫球蛋白G检测的阳性率为93%;磁共振检查发现脑部瘤样脱髓鞘病灶的阳性率为89%;87例患者病灶未出现强化,25例患者占位表现较为明显;79例患者脑组织水肿明显;T1象主要表现为低信号,T2或T2FLAIR主要表现为高信号;DWI表现为混杂信号;ADC表现为高值。结论脑部瘤样脱髓鞘病变后循环供血区域出现较多,病灶无强化,占位不明显,且存在广泛的血管源性水肿,血清NMO-免疫球蛋白G和MRI对于脑部瘤样脱髓鞘具有早期诊断意义,值得临床借鉴。

Objective To analysis the results of NMO-IgG and MRI in neuromyelitis optica with tumefactive demyelinating,and to evaluate the clinical value.Methods From May 2008 to May 2013,100 cases of NMO-IgG and MRI in neuromyelitis optica with tumefactive demyelinating.Statistical analysis of serum NMO-immunoglobulin G-positive cases,MRI image characteristics.Results NMO-positive rate of serum immunoglobulin G detection of 93%;MRI examination revealed a brain tumor-like demyelinating lesions in patients with 89 cases,the positive rate of 89%;87patients not enhanced lesions appear,occupying more obvious manifestations of 25 patients;79 cases of patients with brain edema;T1as mainly as a low signal,T2 or T2FLAIR mainly for high signal;DWI showed mixed signals;ADC showed high values.Conclusion Brain tumor-like demyelinating disease after blood circulation area appears more lesions without enhancement,occupying obvious,and there is a wide range of vasogenic edema,serum NMO-immunoglobulin G and MRI for brain tumor-like demyelinating sheath with early diagnosis,is worthy of reference.