Frohman E M, Zhang H, Kramer P D, Fleckenstein J, Hawker K, Racke M K, Frohman T C
Department of Neurology, University of Texas Southwestern Medical Center, Dallas 02115, USA.
Neurology. 2001 Sep 11;57(5):762-8. doi: 10.1212/wnl.57.5.762.
The authors imaged the medial longitudinal fasciculus (MLF) in 58 patients with MS and chronic internuclear ophthalmoparesis (INO) to determine which MRI technique best shows the characteristic lesion associated with this ocular motor syndrome.
Using quantitative infrared oculography, the authors determined the ratios of abduction to adduction for velocity and acceleration, to confirm the presence of INO and to determine the severity of MLF dysfunction in 58 patients with MS and INO. Conventional MRI techniques, including proton density imaging (PDI), T2-weighted imaging, and fluid-attenuated inversion recovery (FLAIR) imaging, were used to ascertain which technique best shows MLF lesions within the brainstem tegmentum. T1-weighted imaging was performed to determine the frequency of brainstem tegmentum hypointensities.
All patients studied had evidence of an MLF lesion hyperintensity on PDI, whereas T2-weighted imaging and FLAIR imaging showed these lesions in 88% and 48% of patients, respectively. With PDI, dorsomedial tegmentum lesions were seen in the pons in 93% of patients and in the midbrain of 66% of patients. Lesions were observed at both locations in 59% of patients. One patient had an MLF lesion with a corresponding T1 hypointensity.
PDI best shows the MLF lesion in patients with MS and INO.
作者对58例患有多发性硬化症（MS）和慢性核间性眼肌麻痹（INO）的患者的内侧纵束（MLF）进行成像，以确定哪种MRI技术最能显示与这种眼球运动综合征相关的特征性病变。
作者使用定量红外眼动图，确定58例患有MS和INO的患者外展与内收的速度和加速度比值，以确认INO的存在并确定MLF功能障碍的严重程度。使用包括质子密度成像（PDI）、T2加权成像和液体衰减反转恢复（FLAIR）成像在内的传统MRI技术，以确定哪种技术最能显示脑干被盖内的MLF病变。进行T1加权成像以确定脑干被盖低信号的频率。
所有研究患者在PDI上均有MLF病变高信号的证据，而T2加权成像和FLAIR成像分别在88%和48%的患者中显示出这些病变。在PDI上，93%的患者脑桥背内侧被盖有病变，66%的患者中脑有病变。59%的患者在两个部位均观察到病变。1例患者的MLF病变伴有相应的T1低信号。
PDI最能显示MS和INO患者的MLF病变。
