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目的研究MRI未发现病灶的急性脊髓炎(acute myelitis,AM)的临床特点。方法观察并分析6例MRI阴性的AM患者(研究组)和25例MRI发现责任病灶的AM患者(对照组)的临床特点,所有患者符合急性横贯性脊髓炎协作组公布的AM诊断标准。结果研究组有前驱感染的比例显著高于对照组,从前驱感染到AM发病的潜伏期显著短于对照组,脊髓休克期出现的比例显著低于对照组,脊髓完全性横贯性损伤的比例显著低于对照组,治疗效果显著优于对照组,转化为多发性硬化或视神经脊髓炎的比例显著低于对照组。结论与MRI发现责任病灶的AM相比,MRI阴性的AM有其不同的临床特点,对其及时的识别和治疗具有重要的临床意义。
Objective To study the clinical features of acute myelitis (AM) without MRI lesions. Methods The clinical features of 6 patients with MRI-negative AM (study group) and 25 patients with AM who were found to have responsibility lesion by MRI (control group) were observed and analyzed. All patients met the AM diagnostic criteria published by the co-operation group of acute transverse myelitis. Results The ratio of prodromal infection in study group was significantly higher than that in control group. The incubation period from precursor infection to AM was significantly shorter than that in control group. The rate of spinal shock was significantly lower than that in control group. The ratio of complete traumatic spinal cord injury was significantly lower In the control group, the treatment effect was significantly better than the control group, the conversion rate to multiple sclerosis or optic neuromyelitis was significantly lower than the control group. Conclusion MRI-negative AM has different clinical characteristics compared with MRI findings of responsible lesion, which has important clinical significance for its timely identification and treatment.