瘤样脱髓鞘病变不同临床分期增强MRI影像学特征  

Contrast-enhanced MRI Imaging Features of Tumor-like Demyelinating Lesions in Different Clinical Stages

作　　者：金明月 王成雅 谭四平 JIN Ming-yue;WANG Cheng-ya;TAN Si-ping(Department of Neurology,Union Shenzhen Hospital,Huazhong University of Science and Technology,Shenzhen 518052,Guangdong Province,China)

机构地区：[1]华中科技大学协和深圳医院神经内科,广东深圳518052

出　　处：《中国CT和MRI杂志》2023年第3期16-18,共3页Chinese Journal of CT and MRI

基　　金：深圳市南山区卫生健康局计划;深南科【2021】南山区卫生科技计划脑小血管病与血清神经微丝蛋白、同型半胱氨酸水平的相关性研究(NS2021093)。

摘　　要：目的探讨瘤样脱髓鞘病变(TDLs)不同临床分期MRI影像学特征。方法选取2018年4月至2021年2月我院收治的TDLs患者45例,对TDLs进行临床分期,并对患者行MRI影像学.检查,观察患者头颅增强MRI扫描特点。结果5111%的.TDLs病例为多发病灶.,病灶形态以弥漫浸润样(5333%)和环样病灶(4667%)为主,所.有TDLs患者均可见占位效应,急.性期以高信号(68.89%)为主要表现,亚.急性期(5556%)和慢性期(5111%)以稍高信号(5556%)为主要表现。TDLs患者起病以急性期和亚急性期多见,MRI强化随急性期、亚急性期及慢性期而降低,急性期以斑片状和结节样强化为主,亚急性期以开环样强化为主,而慢性期以浅淡斑片状强化为主。结论MRI强化随TDLs临床分期而变化,急性期以斑片状和结节样强化为主,亚急性期演变为开环样强化,慢性期强化信号呈浅淡斑片状或消失,对临床鉴别诊断TDLs具有一定的价值。Objective To investigate the MRI imaging features of tumor-like demyelinating lesions(TDLs)in different clinical stages.Mehods Forty-five patients with TDLs admitted to our hospital from April 2018 to February 2021 were selected for clinical staging of TDLs,and MRI imaging examination was performed on the patients to observe the characteristics of enhanced MRI scan of the patients'head.Results Multiple lesions were found in 51.11%of TDLS cases,and the lesions were mainly diffuse infiltrate(53.33%)and ring like lesions(46.67%).Space occupying effect was observed in all TDLs patients,high signal intensity(68.89%)was the main manifestation in acute phase,and slightly high signal intensity(55.56%)was the main manifestation in subacute phase(55.56%)and chronic phase(51.11%).The onset of TDLs was more common in the acute and subacute stages,and the MRI enhancement decreased with the acute,subacute and chronic stages.In the acute stage,the enhancement was mainly patchy and nodular,in the subacute stage,the enhancement was mainly ring opening,and in the chronic stage,the enhancement was mainly light patchy.Conclusion MRI enhancement varies with the clinical stages of TDLs.In the acute stage,the MRI enhancement is mainly patchy and nodular,in the subacute stage,it evolves into ring-opening enhancement,and in the chronic stage,the enhancement signals are light and patchy or disappear,which has certain value for the clinical differential diagnosis of TDLs.

关 键 词：瘤样脱髓鞘病变 磁共振成像 增强 临床分期 

分 类 号：R744.5[医药卫生—神经病学与精神病学]