多发性硬化症临床表现与MRI分析  

Clinical Manifestation and MRI Analysis of Multiple Sclerosis

作　　者：张超成[1] 左勤学[2] 何劲松[1] 谭湘明[1] 华力明[1] 

机构地区：[1]湘南学院附属医院神经内科,湖南郴州423000 [2]郴州市第一人民医院磁共振室,湖南郴州423000

出　　处：《医学综述》2009年第2期302-303,共2页Medical Recapitulate

摘　　要：目的探讨多发性硬化症（MS）的MRI表现及其与临床症状和体征的关系，以提高诊断水平.方法回顾性分析了90例临床确诊为MS患者的MRI资料，总结了该病的临床和MRI特点。结果MS病灶颅内好发部位依次为侧脑室周围（49.0％），半卵圆中心（25．4％），胼胝体（11．2％）．脑干（7．80％），小脑（6．20％）；脊髓好发节段为颈胸段。90例MS，颅内病灶有381个／73例，其中有232个病灶无临床对应体征，占60．9％；脊髓病灶有51个／47例，其中只有10个无临床对应体征，占19．6％；病灶多呈斑片状，在T1加权像上可为低、稍低或等信号，在T2加权像多为高信号；病灶多为斑片状或斑点状强化MRI特点。结论MS病灶以两侧脑室旁最多见，且病灶数目与临床表现之间无明确关系，而病灶部位与临床关系更密切。Objective To evaluate MRI appearance of multiple sclerosis （MS） and its relationsip with clinical symptom and sign in order to promote the diagnostic level. Methods The clinical and MRI appearance of 90 cases with clinical definitive diagnosis of MS were analyzed retrospectively based on their clinical and MRI feature. Results The location of brain MS lesions were commonly seen in the white matter around lateral ventricles （ 49.0% ） , semiovalcenter （ 25.4% ） , corpuscallosum （ 11.2 % ） , brainstem （ 7.80% ） and cerebrum （6.20%）, The distribution of the spinal cord MS lesions was observed most frequently at cervical cord and thoracic cord. there are 73 samples of MS that the locations of 381 were in the brain. And between 232 lesions and clinical expression without definite relation（60.9% ）. There are 47 samples of MS that the locations of 51 lesions were in the spinal. And between 10 lesions and clinical expression without definite relation （ 19.6 % ）. Patchy like lesion was the most common form in MS. They were showed as low,slightly low or middle signal inintensity in T1 weighted images and high singal intensity in T2 weighted images. These lesions were commonly showed pattwhy or punctuate enhancement after injecting Gd-DTPA. Conclusion The distribution of the lesions was observed most frequently at the two sides of periventricle ,The munber of lesions is not clearly related to clinical expression, while, the location of lesions is closely related to clinical syptom.

关 键 词：多发性硬化症 临床表现 MRI分析 

分 类 号：R445.2[医药卫生—影像医学与核医学]