磁共振三维双反转恢复序列在早期诊断视神经脊髓炎和评价预后的价值

Value of Three Dimensional Double Inversion Recovery Sequence of MRI in Early Diagnosis of Optic Neuromyelitis and Evaluation of Prognosis

目的分析磁共振三维双反转恢复序列(3D-Double Inversion Recovery,3D-DIR)在早期诊断视神经脊髓炎(Neuromyelitis Optica,NMO)和评价预后的价值。方法连续选择50例疑似NMO患者,联合应用血清NMO-IgG定量检测和3D-DIR检查。结果共确诊43例(86.0%)NMO,从发病到确诊时间平均(3.3±0.9)d。脑部呈T1W低信号,T2W和FLAIR高信号,平均累及部位(5.7±1.4)个,分布于侧脑室周围、延髓、大脑白质、三脑室、中脑导水管周围、脑桥、间脑;T1W平均信号强度0.88±0.22,T2W平均信号强度2.69±0.46,FLAIR平均信号强度2.47±0.53。视神经和视交叉呈FLAIR高信号,平均信号强度2.45±0.33。脊髓呈肿胀、坏死、空洞病变,累及中央部位的灰质和白质,呈横贯性;病灶长度平均(4.8±1.2)个椎体。治疗后脑部、视神经和视交叉及脊髓的信号强度均较前降低,差异均有统计学意义(P<0.05)。结论 3D-DIR在早期诊断NMO和评价预后中有重要的应用价值。

Objective To study the values of early diagnosis of neuromyelitis optica(NMO)and prognosis evaluation with three dimensional magnetic resonance double inversion recovery sequence(3D-DIR).Methods A total of50consecutives suspected as NMO were enrolled and detected with serum NMO-IgG level and3D-DIR.Results There were43cases(86.0%)with definite diagnosis of NMO,the mean time from onset to diagnosis was(3.3±0.9)d.The T1W of brain was with low signal,while T2W and FLAIR were both with high signal.The number of mean involved location was5.7±1.4,they were located in lateral ventricle,medulla,cerebral white matter,third ventricle,around the midbrain aqueduct,pons and interbrain.The mean signal intensity of T1W,T2W and FLAIR was0.88±0.22,2.69±0.46and2.47±0.53,respectively.Optic nerve and optic chiasma were with high signal of FLAIR(2.45±0.33).The spinal cord showed swelling,necrosis and cavity,involved in gray and white matters of the central part.The length of lesion was(4.8±1.2)vertebral body.The signal intensity of brain,optic nerve,optic chiasma and spinal were all significantly lower after treatment(P<0.05).Conclusion The3D-DIR is of importance for early diagnosis and prognosis evaluation of NMO.