摘要
目的寻找多发性硬化(multiple sclerosis,MS)患者有诊断及鉴别诊断意义的脑部磁共振成像(MRI)征象.方法分析41例临床确诊MS患者的常规脑部MRI表现,内容包括病灶数目、分布、大小、形态、信号特征及增强表现等.结果脑部的MS灶可以单发和多发,单发者幕下多见,多发者以4～15个病灶者最多.少数病例的病灶弥漫分布,无法计数,呈现'白质变脏征'.斑块分布以两侧脑室旁最多见,其次为额顶叶皮层下、胼胝体、脑干,伴发小脑内病灶仅2例.斑块直径约几个毫米至2 cm不等,约占75%;2 cm 以上病灶者少见,最大病灶约6～7 cm.根据形态和信号,病灶可以分为急性和慢性.急性病灶呈卵圆形或圆形,有明显膨胀感,T1WI呈低或略低信号,周围可见等或略高信号;T2WI呈高信号,但增高程度不同,表现为中央呈'核心'而周围呈'晕环'.此类病灶均表现强化,最典型为环形强化、强化环完整或呈不完整弓形,即使病灶较大仍具有上述特点.慢性病灶也可分为两种,一种为大体对称性的病灶,分布于两侧脑室旁,另一种病灶分布较分散,额、顶叶,侧脑室旁及脑干等处都有,病灶呈小条、片状,部分融合成较大片状.慢性病灶有收缩感,边缘较锐利,信号较均匀,周围无晕环征象,增强后无强化.结论脑部MS有多种MRI表现,部分征象具有特征性.
Objective To obtain magnetic resonance imaging(MRI) symptoms that could be used in medical diagnosis and identification by analyzing the diverse MRI appearance of brain multiple sclerosis(MS).Methods MRI findings of 41 samples of clinically definite MS, including the numbers, distributions, sizes, and shapes of the lesions were analyzed. The symbolic characteristics and enhanced expression are also covered.Results Brain MS might happen singly and multiply, and more frequently with multiple happening. In a multiple case, 4—15 lesions were observed the most. Some samples showed with diffuse lesions which were unable to be counted accurately presenting as a “dirty-appearing white matter”. The distribution of the lesions was observed most frequently at the two sides of periventricle, and following by the subcortical, corpus callosum, and brainstem. Only two lesions were observed at cerebrum. The size of most lesions range from a few millimeters to 2 cm, accounting for about 75% of the total samples. Lesions with size above 2 cm were seen seldomly, with the biggest one of 6—7 cm. According to the shapes and symptoms, lesions might be categorized as an acute and chronic ones. The acute lesions had a shape of oval or circle, with a swelling appearance, low signal of T_1WI, and isointensity or a slightly higher signal on the circle. T_2WI showed a high signal, with different increase and showing “core+lunar” sign. This kind of lesions showed an enhancement with the circle enhancement as the most typical one, which had a complete circle or non-conplete arc shape enhancement, even the big lesions. The chronic lesion might also be divided into two categories. One was the quasi-symmetric lesion, with the distribution along two sides of periventricle and with the shape of small puncture/patch, part of them merged into the big patch; another kind of lesions was found scattered sparsely at frontal, parietal lobes and two sides of the periventricle, with small patches in shape. The chronic lesions had an appearanc
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2005年第3期167-170,共4页
Chinese Journal of Neurology
