多发性硬化与脑小血管病的脑白质高信号特征的差异比较

Comparison of the differences in cerebral white matter hyperintensity characteristics between multiple sclerosis and cerebral small vessel disease

目的探讨无高血压的年轻多发性硬化患者与症状性脑小血管病患者脑白质高信号特征的差异。方法检查了77例多发性硬化患者和88例症状性脑小血管病患者,采用分区病变描述、半定量视觉评分量表和自动像素定量方法对T2图像进行比较。结果多发性硬化白质高信号区病变体积小、数量少,多见于脑室周围和皮质旁白质,尤其见于枕部和颞部。而脑小血管病的白质高信号区病变体积较大,数量较多,多见于皮质下白质,尤其是额叶和基底节区。结论本研究揭示的影像学特征提高了多发性硬化和脑小血管病的鉴别,提示了两种疾病的不同病理性质。

Objective To explore the differences in characteristics of white matter hyperintensity(WMH)between young patients with multiple sclerosis(MS)but without hypertension and patients with symptomatic cerebral small vessel disease(CSVD).Methods Seventy-seven MS patients and 88 symptomatic CSVD patients were examined.T2 images were compared using sub-region lesion descriptions,semi-quantitative visual rating scales and automated pixel quantitative methods.Results The lesions in the WMH areas of MS were smaller in size and fewer in number.They were more common in the periventricular and paracortical white matter,especially in the occipital and temporal regions.In contrast,WMH lesions of CSVD were larger in size and more numerous,and they were more in subcortical white matter,particularly in frontal and basal ganglia regions.Conclusions The imaging features revealed in this study improve the differentiation between MS and CSVD.They suggest the different pathological nature of the two diseases.