Lisanti Christopher J, Asbach Patrick, Bradley William G
Department of Radiology, Wilford Hall Medical Center Lackland AFB, TX, USA.
AJNR Am J Neuroradiol. 2005 Sep;26(8):2033-6.
Corpus callosum lesions are of specific interest in the evaluation of suspected multiple sclerosis in brain MR imaging. Using thin-section sagittal fluid-attenuated inversion recovery images, researchers have shown that the finding of "subcallosal striations" correlates significantly with the diagnosis of multiple sclerosis. Using the same MR imaging technique, we describe a finding of ependymal irregularity that we call the "Dot-Dash" sign, which we believe to be associated with early multiple sclerosis.
Sagittal 2-mm fast fluid-attenuated inversion recovery images were obtained in 70 patients. Thirty-five patients had multiple sclerosis according to the Poser criteria, and 35 were age-matched controls. The images were reviewed in a blinded fashion by an experienced neuroradiologist for the presence or absence of the Dot-Dash sign.
The correlation between the Dot-Dash sign and definite clinical multiple sclerosis is highly significant (P < .001), with a sensitivity of 91.4% and a specificity of 65.7%. In the age group of < or =50 years, the sensitivity was 95.7% and the specificity, 71.9%.
The Dot-Dash sign of ependymal irregularity on thin-section sagittal fluid-attenuated inversion recovery images is an early marker for multiple sclerosis, which is particularly useful in the younger patient. This finding appears to be more sensitive for early lesion detection than any other multiple sclerosis imaging finding yet described in the literature.
在脑部磁共振成像（MR成像）中评估疑似多发性硬化症时，胼胝体病变具有特殊意义。研究人员利用薄层矢状面液体衰减反转恢复（FLAIR）图像显示，“胼胝体下条纹”的发现与多发性硬化症的诊断显著相关。我们采用相同的MR成像技术，描述了一种室管膜不规则的表现，我们称之为“点划线”征，我们认为它与早期多发性硬化症有关。
对70例患者进行了2毫米厚的矢状面快速液体衰减反转恢复成像。根据波泽（Poser）标准，35例患者患有多发性硬化症，35例为年龄匹配的对照组。由一位经验丰富的神经放射科医生以盲法对图像进行检查，以确定是否存在“点划线”征。
“点划线”征与明确的临床多发性硬化症之间的相关性非常显著（P <.001），敏感性为91.4%，特异性为65.7%。在年龄小于或等于50岁的组中，敏感性为95.7%，特异性为71.9%。
薄层矢状面液体衰减反转恢复图像上室管膜不规则的“点划线”征是多发性硬化症的早期标志物，对年轻患者尤其有用。这一发现似乎比文献中描述的任何其他多发性硬化症成像发现对早期病变检测更敏感。
