儿童视神经脊髓炎谱系疾病6大核心临床特征对应的磁共振成像表现  

Six core clinical and magnetic resonance imaging characteristics of neuromyelitis optica spectrum disorders in children

作　　者：周子淇 吴桂鹏 朱玥 王凌 廖欣 ZHOU Zhiqi;WU Guipeng;ZHU Yue;WANG Ling;LIAO Xin(School of Clinical Medicine,Guizhou Medical University,Guiyang 550025,Guizhou,China;School of Medical Imaging,Guizhou Medical University,Guiyang 550025,Guizhou,China;School of Pediatrics,Guizhou Medical University,Guiyang 550025,Guizhou,China)

机构地区：[1]贵州医科大学临床医学院,贵州贵阳550025 [2]贵州医科大学医学影像学院,贵州贵阳550025 [3]贵州医科大学儿科学院,贵州贵阳550025

出　　处：《贵州医科大学学报》2023年第2期165-171,共7页Journal of Guizhou Medical University

基　　金：国家自然科学基金(81960537)。

摘　　要：目的探讨儿童视神经脊髓炎谱系疾病(NMOSD)的6大核心临床特征对应的磁共振成像(MRI)表现。方法收集10例NMOSD患儿临床和影像资料,采用MRI进行头颅、脊髓和眼眶扫描,观察NMOSD的发病部位、形态及影像学特点。结果10名患儿行MRI检查均发现视神经、脊髓或脑内病灶,其中8例视神经异常,6例脊髓异常,5例脑内异常(2例延髓,1例脑桥,1例脑桥和丘脑,1例双侧大脑半球);MRI视神经异常表现为眶内段或视交叉受累,增强扫描可见强化;MRI脊髓异常表现为颈段、胸段、腰段脊髓均可受累,其中5例病变发生在颈胸髓,1例发生在脊髓圆锥,急性期可见脊髓肿胀,慢性期可见脊髓萎缩或空洞;MRI脑内异常表现为延髓、脑桥、第四脑室周围、双侧丘脑、第三脑室周围以及双侧大脑半球白质斑片状稍长T1、稍长T2信号。结论NMOSD的6大核心临床特征均有特异性的MRI表现。Objective To investigate the six core clinical characteristics corresponding to MRI findings of nuromyelitis optica spectrum disorders(NMOSD)in children.Methods The clinical and imaging data of 10 children with NMOSD was collected.The head,spinal cord and orbit were scanned with magnetic resonance scanner to observe the location,morphology and signal characteristics of NMOSD.Results All of the 10 children were found lesions in the optic nerve,spinal cord or brain on MRI.There were 8 cases of optic nerve abnormalities,6 cases of spinal cord abnormalities,and 5 cases of intracerebral abnormalities(2 cases of medulla oblongata,1 case of pons,1 case of pons and thalamus,and 1 case of bilateral cerebral hemispheres).The abnormal optic nerve showed the involvement of the intraorbital segment or optic chiasma,and enhancement could be seen on enhanced scanning.Spinal cord abnormalities include cervical,thoracic and lumbar spinal cord.The lesions occurred in the cervical and thoracic spinal cord in 5 cases,and 1 case in the conus medullaris.Swelling of spinal cord could be seen in the acute phase,and atrophy or syringomyelia of the spinal cord could be seen in the chronic phase.Abnormalities in the brain are manifested as slightly longer T1and T2signals in the medulla oblongata,pons,peripheral fourth ventricle,bilateral thalamus,peripheral third ventricle,and white matter patches in bilateral cerebral hemispheres.Conclusion Six core clinical features of NMOSD correspond to specific MRI findings respectively.

关 键 词：儿童 视神经脊髓炎谱系疾病 磁共振成像 临床特征 诊断 增强扫描 

分 类 号：R445.2[医药卫生—影像医学与核医学]