摘要
采用磁共振成像（ＭＲＩ）与病理对照方法探讨多发性硬化（ＭＳ）ＭＲＩ异常长Ｔ２信号与病理改变的关系。对３例经１０％福尔马林固定的全脑标本（其中１例含脊髓）行自旋回波（ＳＥ）序列扫描，对照ＭＲＩ图像所示的长Ｔ２信号行标本大体及镜下观察。３例ＭＳ均显示有长Ｔ２信号，其病理基础除ＭＳ斑块外还可见坏死软化灶及空洞形成。斑块状长Ｔ２信号具有特征性的ＭＲＩ表现：直角脱髓鞘征，见于病程长者（例１）。坏死软化灶及空洞形成引起的非斑块状长Ｔ２信号形态分布不一，以病程短、起病急者为著（例２、３），后者脊髓受累程度亦严重。ＭＲＩ是诊断ＭＳ最有价值的影像学检查方法。ＭＳ长Ｔ２信号的病理基础除典型硬化斑外还有坏死软化灶及空洞形成。当临床拟诊为ＭＳ，而ＭＲＩ仅显示非斑块状长Ｔ２信号时，应警惕为急性发病的ＭＳ。
ThepurposeofthisreportistodeterminethepathologicfundamentalsofabnormallongT2signalsnotedonmagneticresonanceimagins(MRI)inmultiplesclerosis(MS).TheauthorsmadepostmortemMRimagingson3formalin-fixedbrainspecimensandonespinalcordspecemen.Alstudieswereperformedbyusinga1.0-TSiemensunitwithSpin-echo(SE)imagingsequences.Histologiccorrelationswereobtainedbycuttingthespecimensparaleltotheab-normalsignalsonMRIplanesandexaminingthegeneralycorrespondingareasofthemicroscopicsections.Inalthecases,MRIshowedabnormallongT2signals(hyperintensitiesonT2-weightedimages).Histologicalytheywererelatedtotheareasofnecroses,softenedtissuesandcavityforma-tionsbesidestheclassicalplaques.TypicalMSplaquesweremainlyseenincase1andconsistedofcharacteristicMRappearance,caledtheright-angledemyelinationsigns.Incase2and3,necroses,softenedtissuesandcavityformationswereidentifiedinthebasalganglia,thesubcorticalareas,andthespinalcord,reflectinganacuteandseveredemylinatingchanges.OnMRItherewerelongT2sig-nalswithroundorwedge-Shapedlesionsinmorphology(non-plaquelongT2signals).ItwasconsideredthatMRimagingswouldbevaluableandsensitivetoestablishadiagnosisofMS.ThepathologicalfundamentalsoflongT2signalsinMSwereconfirmedbynecroses,softenedtissues,cavityformations,andtheclassicalplaques.WhenMRIshowedthattherewerenon-plaquewithlongT2signalsinthepatientswhowassuspectedMSbyclinician,acuteMSshouldbenoted.
出处
《中华神经科杂志》
CAS
CSCD
1996年第1期15-18,共4页
Chinese Journal of Neurology
关键词
多发性硬化
NMR
成像
病理
MultiplesclerosisMRimagingNeuropathology
