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目的:了解多发性硬化(multiplesclerosis,MS)的病灶特点。方法:选择确诊的缓解-复发型MS患者203例,每6个月检查头颅MRI一次。结果:①203例MS患者中,172(84.7%)例脑MRI显示脱髓鞘病灶。其中有胼胝体病灶者90例(52%),有脑干病灶者106例(62%),有小脑病灶者46例(28%),有与脑室联结的病灶者157例(91%),有典型的卵圆形病灶者98例(57%),病灶长轴与侧脑室切线垂直的病灶占总病灶一半以上的130例(76%)。②203例MS患者中,大脑半球内和脑内无病灶者分别为41例(20%)和31例(15%)。仅脑干有病灶者6例(3%),仅小脑有病灶者2例(1%),脑干和小脑都有病灶者2例(1%)。③203例共检查827次MRI,有活动病灶者77例(41%),共有活动病灶261个,分布在大脑、小脑和脑干者依次为223、10和28个。结论:①在确诊MS患者中,多数脑MRI有脱髓鞘病灶。②脑内有病灶者中,小脑有病灶者,较欧美报道为低。③T2像发现活动病灶的机率不高,多次复查能提高病灶的检出率。
Objective: To understand the characteristics of lesions of multiple sclerosis (MS). Methods: A total of 203 patients with relapsed MS were selected and diagnosed every 6 months. Results: ①203 cases of MS patients, 172 (84.7%) brain MRI showed demyelinating lesions. Of these, 90 (52%) had corpus callosum lesions, 106 (62%) had brainstem lesions, 46 (28%) had cerebellar lesions, and 157 (91%) had ventricular-associated lesions with The typical oval lesions in 98 patients (57%), the long axis of the lesion and lateral ventricle tangent vertical lesions accounted for more than half of the total lesions in 130 cases (76%). ② Among 203 MS patients, there were 41 cases (20%) and 31 cases (15%) in the hemispheres without brain lesions. Only brain stem lesions in 6 cases (3%), only cerebellar lesions in 2 cases (1%), brain stem and cerebellum lesions in 2 cases (1%). (3) Totally 827 MRIs were examined in 203 patients, 77 patients (41%) had active lesions, and 261 lesions were active. The distributions were 223, 10 and 28 in brain, cerebellum and brainstem. Conclusion: ① In the diagnosis of MS patients, most brain MRI demyelinating lesions. ② There are lesions in the brain, cerebellar lesions, compared with Europe and the United States reported as low. ③ T2 like found that the probability of active lesions is not high, repeated examination can improve the detection rate of lesions.