Cheng Guan-xun, Wu Hua-wang, Zhang Jing, Liang Li-ning, Zhang Xue-lin
Diagnostic Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2008 Aug;28(8):1372-5.
To investigate the magnetic resonance imaging (MRI) feature of multiple cerebral sclerosis (MS) for better understanding and diagnosis of this disease.
The MRI data of 32 patients with MS were reviewed. Conventional scanning with T1WI, T2WI, Flair sequence was performed, and 26 patients underwent Gd-DTPA enhanced scanning. The MS plaques were analyzed for their locations, sizes, shapes, MR signals and enhanced features, space-occupying signs, and the related corpus callosum changes and brain atrophy. Descriptive statistical method was used for all the data.
MRI identified MS lesions in the brain in 30 cases, with the sensitivity of 93.75%. All the MS patients had multiple lesions with predilection sites of the cortical/juxtacortical and periventricle areas, the centrum semiovale, and the corpus callosum. Most of the MS plaques were round or oval of different sizes. Bilateral lesions were almost symmetrical in distribution. Twenty patients had "rectangular demyelination" and 12 had "dirty white matter" signs, and 11 had both manifestations. The lesions were isointense, slightly hypointense or hypointense on T1WI, and hyperintense on T2WI and Flair sequences. Most of the MS plaques presented no enhancement, with occasional nodular or circular enhancement. No or slight space-occupying effect was found in the plaques. Of the 28 MS patients undergoing sagittal scanning of the corpus callosum, 17 presented with abnormal signals, with the sensitivity of 60.71% (17/28). Five patients had corpus callosum atrophy, and 10 had brain atrophy of different degrees.
These results suggest that the corpus callosum is often compromised by the MS lesions to present diffusive, nodular, radiating signal abnormalities and irregular ependymal thickening, which can be most obvious with sagittal FLAIR imaging.
研究多发性脑硬化（MS）的磁共振成像（MRI）特征，以更好地理解和诊断该疾病。
回顾32例MS患者的MRI数据。进行T1WI、T2WI、Flair序列常规扫描，26例患者接受钆喷酸葡胺（Gd-DTPA）增强扫描。分析MS斑块的位置、大小、形状、磁共振信号、增强特征、占位征象以及相关胼胝体变化和脑萎缩情况。所有数据采用描述性统计方法。
MRI在30例患者脑部发现MS病灶，敏感性为93.75%。所有MS患者均有多个病灶，好发部位为皮质/皮质下、脑室周围区域、半卵圆中心和胼胝体。大多数MS斑块为不同大小的圆形或椭圆形。双侧病灶分布几乎对称。20例患者有“矩形脱髓鞘”表现，12例有“脏白质”征象，11例两者均有。病灶在T1WI上呈等信号、稍低信号或低信号，在T2WI和Flair序列上呈高信号。大多数MS斑块无强化，偶尔有结节状或环状强化。斑块未见或仅有轻微占位效应。28例接受胼胝体矢状位扫描的MS患者中，17例出现异常信号，敏感性为60.71%（17/28）。5例患者有胼胝体萎缩，10例有不同程度的脑萎缩。
这些结果表明，胼胝体常受MS病灶累及，表现为弥漫性、结节状、放射状信号异常和室管膜不规则增厚，矢状位FLAIR成像显示最为明显。
