视神经脊髓炎颅脑MRI表现

Brain MRI manifestations of neuromyelitis optica

目的观察视神经脊髓炎(NMO)患者颅脑MRI表现。方法回顾性分析50例NMO患者的临床和MRI表现。将脑MRI表现分为未见异常改变、非特异性病灶、类多发性硬化病灶和NMO特异性病灶(水通道蛋白-4主要分布区的融合性病灶)。对40例行NMO-IgG抗体检测。结果 50例NMO患者中,35例脑MRI未见异常改变。15例MR检查发现病灶,其中NMO特异性病灶7例、病灶分布于下丘脑、脑桥和脑室周围,类MS病灶3例,非特异性病灶5例。NMO-IgG抗体阳性率65.00%(26/40)。结论大多数NMO患者脑MRI未见异常改变,部分典型表现患者病灶分布于下丘脑、脑桥和脑室周围,与水通道蛋白-4的主要分布区一致。

Objective To observe the brain MRI findings of neuromyelitis optica（NMO）.Methods The clinical and MRI manifestation of fifty patients with NMO were analyzed retrospectively.The brain MRI findings were classified into four types,i.e.normal,nonspecific,multiple sclerosis-like（MS-like）and typical abnormalities.Confluent lesions involving high aquaporin-4（AQP-4）regions were considered typical abnormalities.The NMO-IgG antibody was performed in40 patients.Results In 50 patients with NMO,brain MRI revealed no abnormalities in 35 cases.Brain lesions were delineated by MRI in 15 patients,among them,typical abnormalities in 7 patients,with the lesions located at hypothalamus,brainstem or peri-ventricle,MS-like lesions in 3 patients,and nonspecific lesions in 5 patients.NMO-IgG antibody were positive in 26 patients（26/40,65.00%）.Conclusion Brain MRI findings are negative in most patients with NMO.The typical lesions locate at hypothalamus,brainstem or peri-ventricle,corresponding to distribution of AQP-4in the brain.