摘要： 目的 分析多发性硬化脊髓受累患者临床表现及MRI 影像学特点，并探讨其临床诊断意义。方法 回顾分析2006 年1 月-2009 年12 月住院治疗的46 例多发性硬化脊髓受累患者的临床资料及影像学表现。结果 起病形式以急性（58.70%，27/46）或亚急性（34.78%，16/46）为主，临床主要表现为肢体瘫痪（95.65%，44/46）、感觉障碍（84.78%，39/46）和尿潴留（67.39%，31/46）。MRI受累部位以颈髓最常见（45.65%，21/46），其次为胸髓（28.26%，13/46），呈脊髓内单一或散在多发长T1、长T2 斑片状异常信号影，病灶长度一般不超过2 个椎体节段（84.78%，39/46），个别患者（15.22%，7/46）病灶长度超过2 个椎体节段；增强扫描可有不同程度强化（78.26%，36/46）。结论 多发性硬化脊髓受累患者临床表现复杂多样，MRI 脊髓受累可呈现单一或散在多发病灶，病灶长度较少超过2 个椎体节段，但病灶节段延长不能排除多发性硬化。MRI是诊断多发性硬化脊髓受累最敏感和最特异的影像学检查方法。
关键词:
多发性硬化,
脊髓疾病,
磁共振成像,
病例对照研究
Abstract: Objective To analyse the significance of clinical manifestations and magnetic resonance imaging (MRI) features in clinical diagnosis of multiple sclerosis (MS) involved with spinal cord. Methods The clinical data and MRI features of 46 inpatients with spinal cord involvement of multiple sclerosis from January 2006 to December 2009 were analysed retrospectively. Results The main onset type of the patients was acute (58.70% , 27/46) or sub-acute (34.78% , 16/46). The main clinical manifestations were acroparalysis (95.65%, 44/46), sensory disturbance (84.78%, 39/46) and retention of urine (67.39%, 31/46). MRI showed that cervical involvement was most common (45.65%, 21/46) which was followed by thoracic involvement (28.26% , 13/46). Single or multiple scattered long T1 and T2 abnormal signal patches were seen, and the lesion often involved 2 or less than 2 vertebrae (84.78%, 39/46) and might involve more than 2 vertebral segments (15.22%, 7/46). Different signal intensity was seen on enhanced scanning. Conclusion The clinical manifestations of patients with multiple sclerosis involved spinal cord are diverse. MRI shows that spinal cord involvement presents single or multiple lesions which usually do not involve more than 2 vertebral segments. Even if the lesion segment is extended, multiple sclerosis can not be excluded. MRI is the most sensitive and most specific imaging method to diagnose multiple sclerosis involved spinal cord.
Key words:
Multiple sclerosis,
Spinal cord diseases,
Magnetic resonance imaging,
Case-control studies
沈雪莉，卢希，张斯萌，崔梦遥. 多发性硬化脊髓受累临床与MRI对照研究[J]. 中国现代神经疾病杂志, 2011, 11(1): 96-98.
SHEN Xueli, LU Xi, ZHANG Simeng, CUI Mengyao. Analysis of clinical manifestations and MRI features in multiple sclerosis involved with spinal cord[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2011, 11(1): 96-98.