长节段脊髓病变的常见病因及影像学特征分析  

Longitudinally extensive spinal cord lesion： etiology and imaging features

作　　者：矫毓娟[1] 张伟赫[1] 李小璇[1] 汪伟[1] 刘蕾[1] 张志勇[1] 刘尊敬[1] 汪仁斌[1] 谢晟[2] 焦劲松[1] 

机构地区：[1]卫生部中日友好医院,神经内科,北京100029 [2]卫生部中日友好医院,放射诊断科,北京100029

出　　处：《中华医学杂志》2014年第41期3229-3233,共5页National Medical Journal of China

摘　　要：目的 探讨长节段脊髓病变（LESCL）的病因及影像学特征.方法 连续收集中日友好医院神经内科2011年1月至2013年8月收治的LESCL患者,进行统计并做病因学及MRI特征分析.结果 51例患者中,视神经脊髓炎谱系疾病（NMOSD） 25例,孤立性长节段脊髓炎6例,亚急性联合变性4例,多发性硬化（MS）、副肿瘤性脊髓病变、脊髓前动脉综合征各3例,急性播散性脑脊髓炎和硬脊膜动静脉瘘各2例,脊髓转移瘤、白血病脊髓浸润以及脊髓中央管扩张各1例.NMOSD多是脊髓中心为主的横贯性、纵向延伸的连续性长T2病变,急性期脊髓肿胀明显,增强扫描可见部分强化;其他疾病的MRI表现也各有特点.结论 LESCL的病因复杂,每组疾病的MRI表现虽特异性有限,但仍在一定程度上有助于病因确立.Objective To explore the etiologies and imaging features of longitudinally extensive spinal cord lesion （LESCL）.Methods The etiologies and magnetic resonance （MR） imaging features of 51 hospitalized LESCL patients from January 2011 to August 2013 were reviewed and retrospectively analyzed.Results Among them,the causes were neuromyelitis optica spectrum disorder （NMOSD,n =25）,isolated longitudinally extensive transverse myelitis （n =6）,subacute combined degeneration （n =4）,multiple sclerosis （MS,n =3）,paraneoplastic myelopathy （n =3）,anterior spinal artery syndrome （n =3）,acute disseminated encephalomyelitis （n =2）,spinal dural arteriovenous fistula （n =2）,intramedullary spinal cord metastasis （n =1）,myelopathic leukemia （n =1） and syringomyelus （n =1）.For MR imaging,at least one lesion of each patient presented continuously longitudinal profile and whole-length spinal cord was involved in 11 patients.Conclusion LESCL may be caused by various diseases.And the imaging features may aid its diagnosis despite a lack of specificity.

关 键 词：脊髓病 视神经脊髓炎 水通道蛋白4 多发性硬化 磁共振成像 

分 类 号：R744[医药卫生—神经病学与精神病学]