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1例成人T细胞白血病病毒I型相关脊髓病伴脊髓MRI片状异常病灶

[A case of HTLV-I associated myelopathy with abnormal patchy MRI lesions in the spinal cord].

作者信息

Yanagihara C, Nakaji K, Nishimura Y

机构信息

Department of Neurology, Nishi-Kobe Medical Center, Japan.

出版信息

Rinsho Shinkeigaku. 2000 Mar;40(3):254-8.

Abstract

We report a case of HTLV-I associated myelopathy (HAM) with a spinal cord MRI showing abnormal multifocal and patchy lesions. A 50-year-old woman suffering from progressive paraparesis was admitted to our hospital. HTLV-I antibodies in the serum and CSF were positive, and a diagnosis of HAM was made. Her T2 weighted spinal cord MRI showed scattered areas of high signal intensity from the cervical to the thoracic cord. The lesions were enhanced with gadolinium-DTPA on T1 weighted imaging. Atrophy of the thoracic cord has been reported in many patients with HAM. In rare cases, T2 weighed thoracic cord MRI showed diffuse high signal intensity. The pattern of high signal intensity in our case, however, was multifocal and patchy, thus differing from the findings of previous reports. And we believe this is the first such report. This case suggests that the MRI of HAM patient may show multifocal and scattered lesions in the spinal cord.

摘要

我们报告一例人类嗜T淋巴细胞病毒I型(HTLV-I)相关脊髓病(HAM),其脊髓MRI显示多发异常斑片状病灶。一名患有进行性双下肢轻瘫的50岁女性入住我院。血清和脑脊液中的HTLV-I抗体呈阳性,诊断为HAM。她的脊髓T2加权MRI显示从颈髓到胸髓有散在的高信号区。在T1加权成像上,病灶经钆喷酸葡胺增强。许多HAM患者都有胸髓萎缩的报道。在罕见病例中,胸髓T2加权MRI显示弥漫性高信号。然而,我们病例中的高信号模式是多发且斑片状的,因此与先前报道的结果不同。并且我们认为这是首例此类报告。该病例提示,HAM患者的MRI可能显示脊髓内多发散在病灶。

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