摘要
目的:探讨脊髓型多发性硬化(MS)的MRI表现及其病理基础,评价MRI对MS临床分期价值.方法:脊髓型MS患者43例,按临床特点分为急性期、静止期和缓解复发期.对所有患者行头部和脊柱磁共振检查,分析各期的MRI表现.结果:脊髓型MS的主要MRI表现为髓内长或等T1、长T2信号改变.脊髓型MS各期的MRI特点:①急性期11例,均表现为脊髓轻度～中度肿胀,增强扫描时10例(90.9%)髓内病灶有明显强化,其中9例呈斑片状或边缘环状强化,1例呈结节状强化,范围明显小于T2WI上所见;1例无强化.4例伴脊髓中央管扩张.有8例经治疗后病灶缩小,脊髓肿胀消失.②静止期17例,14例(82.4%)脊髓形态、大小未见异常,髓内病灶均无强化.③缓解复发期15例中,11例(73.3%)伴有脊髓萎缩,增强扫描时5例出现轻度点状或条状强化,病变范围与T2WI所见相似.各期脊髓型MS的病变范围及分布差异无显著性意义(P＞0.05).结论:MRI能反映脊髓型MS各期的病理变化,对脊髓型MS的分期具有重要价值.
Objective：To evaluate the MRI manifestations in different clinical stages of spinal cord multiple sclerosis （MS）. Methods： 43 cases of spinal cord MS which were divided into acute, resting and remitting-relapsing stage according to clinic settings, had brain and spinal cord MRI, and their MRI findings were analyzed retrospectively. Results： The MRI manifestations of spinal cord MS were intra-spinal cord well-defined patches with hypo-/iso-intensity on T1 WI and hyper-intensity on T2 WI. In the acute stage （n：=11）,the diseased spinal cords were slightly to moderately swollen in all cases, showing patchy or ring-like enhancement （n=9） and nodular enhancement （n=1） after intravenously administration of Gd-DTPA, enhancement of the lesions were obviously smaller than that shown on T2WI：There was no enhancement in 1 case. 4 cases had dilatation of central canal of spinal cord. Reduction of the size of lesion and swollen of spinal cord were shown after steroid therapy （n=8）. In the resting stage （n=17）,the shape and size of spinal cord were normal in 14 cases（82.4%）, with no enhancement of the spinal cord lesion after intravenously administration of Gd-DTPA. In the remitting-relapsing stage, 9 cases （73.3%） had spinal cord atrophy, showing dotted or linear enhancement in 5 cases. There were no significant difference in the extent and distribution of lesions in different clinical stages. Conclusion： MRI was helpful in the evaluation of the clinic stage and their pathologic changes of spinal cord MS, and played important role in the clinical application of spinal cord MS staging.
出处
《放射学实践》
2005年第9期761-764,共4页
Radiologic Practice
关键词
磁共振成像
多发性硬化
脊髓
Magnetic resonance imaging
Multiple sclerosis
Spinal cord
