PDF《多发性硬化42例临床表现和MRI结果分析》

56 [文章编号】1000-2200(2008)01-0056-03 ・临床医学・ 多发性硬化42例临床表现和MRI结果分析 王靖东,吴承志,吕晓侠,马锐 [摘要】目的:总结多发性硬化(multiple sclerosis,MS)的临床和MRI特点,提高MS的I临床诊断水平.

方法:回顾性分析42例MS的I临床表现和MRI资料及治疗情况.结果:MS多见于中青年女性,急性或亚急性发病.26例病前有诱因,主要与感染有 关,首发症状以肢体无力和视力减退为多见,复发一缓解型32例,病变部位中脊髓29例,视神经28例,大脑半球14例,脑干8 例,小脑4例,发作性症状14例.MRI检查脑部病灶多位于侧脑室周围和胼胝体,病灶多呈卵圆形,大部分病灶与侧脑室壁切 线垂直或相连;

脊髓病灶位于颈髓和胸髓,与脊髓长轴一致的长条状或多发非连贯性条索状,位于脊髓后外侧,激素治疗后大 部分病灶可缩小或消失.急性期及亚急性期组均有明显疗效,慢性起病者也有改善.结论:结合MS的临床表现和脑部及脊 髓MRI结果,可以提高对MS诊断的准确性. 【关键词]多发性硬化;

磁共振成像;

临床表现 [中国图书资料分类法分类号】R 744.51;

R 445.2 [文献标识码]A Analysis of clinical manifestation and MRI of

42 patients谢th multiple sclerosis WANG Jing―dong,WU Cheng-zhi,Lt3 Xiao-xia,MA Rui (Department ofNeurology,Huaibei Miners General Hospital,Anhui 235000,China) [Abstract]Objective:To summarize the clinical and MRI characteristics ofmultiple sclerosis(MS)and to improve the diagnosis ofthe disease.Methods:The clinical manifestation and MRI appearance of

42 cases of MS were analyzed retrospectively.Results:MS WSg commonly seen in young and middle aged females and the onsets were acute or subaeute.Twenty-six of the cases had evoking factors before onset,which were mainly relevant to infections.Weakness and visual deterioration were the most common initial symptoms. Thirty-two of the cases had relapses.The lesion WaS observed in the spinal cord in

29 cases,in the optic nerve in

28 cases,in the cerebral hemisphere in

14 cases,in the brain stem in

8 Cases and in the cerebellum in

4 cases.Fourteen cases had paroxysmal symptoms.As shown by MRI.the intra.brain focus Was mainly located around the lateral ventricles and corpus callosum.Oval lesion WaS the most common form.Most of the lesions were closely adjacent to the lateral ventricle or their long―axis was perpendicular with the tangent line of the lateral ventricle.Intra-spinal loci were in the cervical and thoracic cord,which were long-strip or multiple noncontinuous fusiform,and located posteriolaterally in the spinal cord.After treatment with corticostemids.most of the focal lesions were reduced or disappeared.Conclusions:Diagnosis of MS could be improved by combining the clinical manifestation with the MR/of brain and spinal cord. [Key words]multiple sclerosis;

magnetic resonance imaging;

clinical manifestation 多发性硬化(multiple sclerosis,MS)是一种以导 致中枢神经系统白质多发性脱髓鞘为主的自身免疫 性疾病,大多数患者在青壮年期发病,临床表现为空 间和时间上的多发性,病程大部分呈复发一缓解形 式,但有逐渐加重并最终导致病残的趋势.我国MS 的特点之一是视神经与脊髓受累频率最高,随着 MRI的临床应用,近年我国MS的确诊率呈上升趋 势.本文报道我院42例MS的临床表现与MRI检 查结果,旨在提高对本病的诊断准确性. 1临床资料 1.1一般资料收集我科1996年1月一2006年8 月临床与MRI资料完整的42例MS病例,均符合 [收稿日期]2007-04-03 [作者单位]安徽省淮北矿工总医院神经内科,235000 [作者简介]王靖东(1967一),男,副主任医师. Poser等…提出的诊断标准中临床确诊或临床很可 能MS.其中男16例,女26例;