多发性硬化脑内磁共振病灶分布及其特征(英文)

Distribution and characteristics of focal lesions in intracerebral MRI of multiple sclerosis

目的:了解多发性硬化(multiplesclerosis,MS)的病灶特点。方法:选择确诊的缓解-复发型MS患者203例,每6个月检查头颅MRI一次。结果:①203例MS患者中,172(84.7%)例脑MRI显示脱髓鞘病灶。其中有胼胝体病灶者90例(52%),有脑干病灶者106例(62%),有小脑病灶者46例(28%),有与脑室联结的病灶者157例(91%),有典型的卵圆形病灶者98例(57%),病灶长轴与侧脑室切线垂直的病灶占总病灶一半以上的130例(76%)。②203例MS患者中,大脑半球内和脑内无病灶者分别为41例(20%)和31例(15%)。仅脑干有病灶者6例(3%),仅小脑有病灶者2例(1%),脑干和小脑都有病灶者2例(1%)。③203例共检查827次MRI,有活动病灶者77例(41%),共有活动病灶261个,分布在大脑、小脑和脑干者依次为223、10和28个。结论:①在确诊MS患者中,多数脑MRI有脱髓鞘病灶。②脑内有病灶者中,小脑有病灶者,较欧美报道为低。③T2像发现活动病灶的机率不高,多次复查能提高病灶的检出率。

AIM:To understand the focal characteristics of multiple sclerosis(MS). METHODS:Totally 203 patients confirmed as remission-relapse MS were selected for cerebral MRI every 6 months. RESULTS:In the 203 MS patients, MRI showed that demyelinating focus was found in 172 cases(84.7%) ,including 90(52%) of corpus callosum focuses,106(62%) of brainstem focuses,46(28%) of cerebellum focuses, 157(91%) of focuses connected with ventricles,98(57%) of typical oval focuses,and 130(76%) of focal ling axis perpendicular to the tangent of lateral ventricle.In the 203 MS patients,41(20%) and 31(15%) had no focuses in cerebral hemisphere and intracephalic respectively,6(3%) only had focuses in brain stem,2(1%) only had focuses in cerebellum,and 2(1%) had focuses in both brain stem and cerebellum.A total of 827 times of MRI were carried out in the 203 patients,in which 77(41%) cases of active focuses, and a total of 261 active focuses were found, in which 223,10 and 28 focuses were at cerebrum,cerebellum and brain stem respectively. CONCLUSION:Most of the confirmed MS patients have demyelinating focuses in MRI. Fewer patients have focuses in cerebellum as compared with Europe and USA.The rate of active focuses discovered by T2 imaging is not high,and the detectable rate can be increased by re-examinations.