资源描述：
《急性播散性脑脊髓炎MRI表现》由会员上传分享，免费在线阅读，更多相关内容在行业资料-天天文库。
1、JournalofMedicalForumVol.27No.6March2006·15·急性播散性脑脊髓炎MRI表现窦国胜薛文俊平顶山市第一人民医院平顶山市467000摘要目的描述急性播散性脑脊髓炎的脑部MRI表现及临床特点。探讨MRI对本病的诊断价值。方法符合临床诊断标准的急性播散性脑脊髓炎患者21例,18例发病前有病毒感染或疫苗接种史。全部病例行头部MRI检查,18例行MRI复查。结果病变多发,不对称,大脑白质受累21例,16例同时累及丘脑,13例可见“垂直征”,19例异常增强,15例复查见异常信号缩小且数目减少。结论急性播散性脑脊髓
2、炎均有脑部MRI改变且颇具特征性。结合病史及单相病程可作出早期诊断,MRI随诊是评价疗效的重要手段,MRI显示丘脑受累可作为鉴别本病与多发性硬化的主要依据。关键词脑脊髓炎急性播散性磁共振成像脑疾病中图分类号:R814142文献标识码:B文章编号:167223422(2006)0620015203ClinicalandBrainMRIStudyofAcuteDisseminatedEncephalomyelitisDOUGuosheng,XUEWenjunTheFirstPeople'sHospitalofPingdingshanCity,
3、Pingdingshan467000,ChinaABSTRACTObjectiveTodescribetheMRIfindingsofthebraininacutedisseminateden2cephalomyelitis(ADEM)anditsclinicalfeaturesandtoevaluatetheusefulnessofMRIimagingindi2agnosingADEMandassessingthetherapy.Methods21casesofclinicallyprovenADEMwereretro2spective
4、lyreviewed.18patientshadahistoryofviralinfectionorvaccinationpriortotheonsetofADEM.MRIscanningofthebrainwasperformedinallcasesinacutestageandfollow-upMRIima2gingwasachievedin18cases.ResultsMultipleandasymmetricallesionswererevealedinthewhitematter(21cases),thalami(16cases
5、).Thepatternofperpendiculardistributionagainstthelateralventricleswasdetectedin13cases.Contrastenhancementwasobservedin19cases.Follow-upMRIimagingshowedthattheabnormalsignalsdecreasedinbothsizeandnumberin15cases.ConclusionAbnormalsignalsareinallthepatientswithADEMandtheyh
6、avesomecharacteristicsbywhichear2lydiagnosiscouldbemadeifcombinedwiththehistoryandmonophasicclinicalsetting.Follow-upMRIimagingplaysanimportantroleinfurtherconfirmingthediagnosisandinevaluatingthetherapyaswell.ThalamicinvolvementasshownbyMRIimagingprovedusefulindistinguis
7、hingbetweenADEMandmultiplesclerosis.KEYWORDSEncephalomyelitis;Acutedisseminated;Magneticresonanceimaging:Braindiseases急性播散性脑脊髓炎(acutedisseminateden21资料与方法cephalomyelitis,ADEM),是一种较少见的中枢神经系统脱髓鞘疾病,多数在发病前1～2周有病毒感111病例选择符合ADEM诊断标准患者21染或疫苗接种史,临床表现多样且无特征性。笔例,男18例,女3例,年龄5～46岁,平均
8、21岁。者收集了符合ADEM诊断标准的患者21例,对其112临床表现4例发病前1周患腮腺炎,3例2临床表现及脑部MRI表现作一回顾性分析。周前感染单纯疱疹病毒,3例注射狂犬疫苗2d后发病,4例
