Li Y, Xie P, Lv F, Mu J, Li Q, Yang Q, Hu M, Tang H, Yi J
Department of Radiology, The First Affiliated Hospital, Chongqing Medical University, Chongqing, China.
Acta Neurol Scand. 2008 Oct;118(4):218-25. doi: 10.1111/j.1600-0404.2008.01012.x. Epub 2008 Mar 31.
Brain abnormalities in neuromyelitis optica (NMO) attracted much attention. Our study was to identify the brain magnetic resonance imaging (MRI) abnormalities in Chinese NMO patients.
Patients who fulfilled the latest diagnostic criteria of NMO proposed by Wingerchuk et al. [Neurology 66 (2006) 1485] and whose brain MRI did not meet the multiple sclerosis (MS) criteria of McDonald et al. [Ann Neurol 50 (2001) 121] were selected to perform MRI scanning of the brain, spinal cord and optic nerves.
Twenty-eight of 33 patients (84.8%) had abnormal MRI findings. Twenty-two patients (66.7%) presented with well-defined brain parenchymal lesions and the other six patients (18.2%) with macroscopic symmetrical diffuse hyperintensities in deep white matter. Fifteen of 22 patients had more than one lesion (> or =2 lesions) and the other seven patients had single lesion. In the supratentorium, most lesions were punctate or small round dot and non-specific in juxtacortical, subcortical and deep white matter regions, a few were patchy atypical confluent lesions. Brainstem was easily involved (14/33, 42.4%) especially in medulla (7/33, 21.2%).
This study demonstrates the characteristics of brain MRI abnormalities in Chinese NMO patients, which are helpful to the revision of diagnostic criteria for NMO.
视神经脊髓炎（NMO）的脑异常备受关注。我们的研究旨在确定中国NMO患者的脑磁共振成像（MRI）异常情况。
选取符合Wingerchuk等人[《神经病学》66（2006）1485]提出的NMO最新诊断标准且脑MRI不符合McDonald等人[《神经病学纪事》50（2001）121]的多发性硬化（MS）标准的患者，对其脑、脊髓和视神经进行MRI扫描。
33例患者中有28例（84.8%）MRI检查结果异常。22例患者（66.7%）表现为边界清晰的脑实质病变，另外6例患者（18.2%）深部白质出现宏观对称性弥漫性高信号。22例患者中有15例有不止一个病灶（≥2个病灶），另外7例患者有单个病灶。在幕上，大多数病灶为点状或小圆形，在皮质旁、皮质下和深部白质区域无特异性，少数为斑片状非典型融合病灶。脑干易受累（14/33，42.4%），尤其是延髓（7/33，21.2%）。
本研究展示了中国NMO患者脑MRI异常的特征，有助于修订NMO的诊断标准。
