多发性硬化与视神经脊髓炎患者磁共振检查的对比研究  

Study of magnetic resonance imaging on differential diagnosis between multiple sclerosis and neuromyelitis optica

作　　者：陈培材 饶俊平 宋宏中 余利生[1] 罗凌云[1] 戴永强[2] Chen Peicai;Rao Junping;Song Hongzhong;Yu Lisheng;Luo Lingyun;Dai Yongqiang

机构地区：[1]中山大学附属第三医院粤东医院神经内科,梅州514000 [2]中山大学附属第三医院神经内科,广州510630

出　　处：《新医学》2016年第7期457-461,共5页Journal of New Medicine

摘　　要：目的探讨MRI对多发性硬化(MS)和视神经脊髓炎(NMO)的鉴别价值。方法92例MS患者(MS组)和57例NMO患者(NMO组)在发病急性期(发病30 d内)均接受了头颅MRI扫描,其中49例MS患者和57例NMO患者还接受了全脊髓MRI扫描,比较2组MRI表现的差异。结果 MS患者和NMO患者的MRI表现存在多种差异,NMO组头颅病灶的检出率明显低于MS组(57.89%vs.96.74%,P<0.05)。相比NMO组,MS组更多患者符合Barkhof空间多发标准(59.78%vs.8.77%,P<0.05)。NMO组强化病灶、皮层下病灶、小脑病灶出现率均少于MS组(P均<0.05)。NMO患者脊髓病灶的出现率、出现强化、脊髓肿胀率及线样征的出现率均高于MS组,病灶纵向长度明显超过MS患者(P均<0.05)。结论 MRI对MS和NMO有较高的鉴别价值。Objective To evaluate the differential diagnostic value of magnetic resonance imaging(M RI) between multiple sclerosis (M S) and neuromyelitis optica (N M O ). Methods Ninety two MS ( MSgroup) and 57 NMO patients (NMO group) underwent head MRI during the acute onset stage ( within 30 d afteronset). Among them, 49 MS and 57 NMO cases received spinal MRI. The MRI characteristics between twogroups were statistically compared. Results The MRI findings significantly differed between the MS and NMOpatients. Compared with the NMO group, MS patients had a significantly higher risk of brain lesion (96. 74%vs. 57. 89% , P <0. 05) , and a significantly higher proportion of MS patients met Barkhof criteria (59. 78%vs. 8. 77% , P <0. 0 5 ). The incidence of enhanced lesion, subcortical lesion and cerebellar lesion in the NMOgroup was considerably lower compared with that in the MS group ( all P <0. 0 5 ). Compared with MS patents,NMO counterparts had a significantly higher incidence of spinal cord lesion, enhanced lesion, spinal cord edemaand string signs and a considerably larger vertical diameter of the lesion (all P <0. 0 5). Conclusion MRIexamination is of clinical significance in the differential diagnosis between MS and NMO.

关 键 词：多发性硬化 视神经脊髓炎 磁共振检查 

分 类 号：R744.5[医药卫生—神经病学与精神病学]