视神经脊髓炎脑部受累的MRI特征性影像表现及临床分析  

MRI features and clinical analysis of brain involvement in optic neuromyelitis

作　　者：张倩倩 张体华[2] 周玫娟[2] 钱伟军 ZHANG Qianqian;ZHANG Tihua;ZHOU Meijuan;QIAN Weijun(Department of Imaging,Kaifeng Central Hospital,Kaifeng 475000,China;Shangqiu Medical College,Shangqiu 476000,China)

机构地区：[1]开封市中心医院影像科,河南开封475000 [2]商丘医学高等专科学校,河南商丘476000

出　　处：《中国实用神经疾病杂志》2018年第21期2367-2372,共6页Chinese Journal of Practical Nervous Diseases

基　　金：河南省高等教育教学改革研究与实践项目(编号:2017SJGL649)

摘　　要：目的分析成人视神经脊髓炎脑部影像表现及临床特点。方法回顾分析2010-10—2017-10开封市中心医院收治的25例视神经脊髓炎患者为研究对象,并行头颅及脊髓MRI检查,根据头颅MRI检查结果,将有脑部病灶的患者纳入研究病例。结果采用1.5T MR扫描仪对患者头部和脊髓进行检查获取MRI图像结果显示:25例患者中头部MRI检查中出现脑部病变者16例,未见出现脑部病变9例。病变主要位于延髓、脑桥、侧脑室周围、第三室周围、中脑导水管、胼胝体、大脑白质等处,根据病灶形态可分为斑片状、斑点状、线样状、融合型,不规则型,常见病灶为散在不规则斑片状、斑点状。15例患者MRI增强检查未见明显强化,1例患者病灶呈轻度强化。16例患者中均出现视神经和脊髓以外的中枢神经系统损害。结论大多数视神经脊髓炎患者都会伴有脑部病变,绝大多数病灶部位与患者的临床表现具有对应关系,病变部位易伴发相应临床的表现。Objective Analysis of brain imaging features and clinical features of adult optic nerve myelitis.Methods From October 2010 to October 2017,25 cases of optic neuromyelitis treated in Kaifeng Central Hospital were retrospectively analyzed.The head and spinal cord MRI were performed.According to the results of cranial MRI,the patients with brain lesions were included in the study.Results The head and spinal cord of the patients were examined by 1.5T MR scanner.Of the 25 patients,16 had brain lesions in MRI examination,9 had no brain lesions.The lesions were mainly located in the medulla oblongata,pontine,lateral ventricle,and around the third ventricle.The midbrain aqueduct,corpus callosum,and white matter of the brain can be divided into patchy,speckled,linear,fused,multiple sclerosing,irregular,and irregular lesions according to the shape of the lesions.There was no obvious enhancement on MRI enhancement in 1 case.The optic nerve and the central nervous system outside the spinal cord were damaged in all of the 16 patients.Conclusion Most patients with optic nerve spondylitis have brain lesions,most of the lesions are associated with the clinical manifestations of the patients,and the lesions tend to accompany the clinical findings.

关 键 词：视神经脊髓炎 脑部受累 磁共振成像 临床特点 脱髓鞘 

分 类 号：R774.6[医药卫生—眼科]