Sierra-Marcos Alba, Mitjana Raquel, Castilló Joaquín, Edo Mari Carmen, Horga-Hernández Alejandro, Tintoré Mar, Río-Izquierdo Jordi, Auger-Acosta Cristina, Rovira Alex, Montalban Xavier
Centre d'esclerosi multiple de Catalunya, Barcelona, Espana.
Rev Neurol. 2010 Aug;51(3):129-34.
The widespread application of magnetic resonance imaging (MRI) has brought with it an increase in the detection of alterations in the white matter of the central nervous system. AIM. To investigate the evolution of patients with no previous neurological symptoms, but in whom MRI findings are highly suggestive of multiple sclerosis (MS).
We conducted a descriptive study of 11 patients with MRI findings suggesting MS. A longitudinal follow-up was used to determine the radiological progression and conversion into an isolated neurological syndrome and clinically defined MS.
Eleven patients (seven females and four males) were identified, with a mean age of 36 years (range: 28-48 years), who had been submitted to an MRI scan due to headache (n = 2), radiculalgia (n = 3), traumatic brain injury (n = 1), syncope (n = 1), peripheral nervous pathology (n = 1) and epileptic seizures (n = 1). The mean number of Barkhof-Tintore criteria in the initial MRI scan was three. The oligoclonal band study was positive in six cases and in nine patients visual evoked potentials were performed (three pathological). The mean follow-up time was 2.9 years (range: 2 months-11.9 years). The mean amount of time elapsed between the first and the second MRI scan was 2.03 years. A radiological progression was identified in seven cases (five of them with gadolinium uptake). Five patients became cases of isolated neurological syndrome, with a mean amount of time since the initial MRI scan of 4.13 years. Of these, three patients presented conversion into clinically defined MS, two into the relapsing-remitting form (after an average of 8.54 years since the initial MRI scan) and another into the primary progressive form.
The identification of incidental lesions that are highly suggestive of MS could help to constitute a group of subjects with an increased risk of developing MS.
磁共振成像（MRI）的广泛应用使得中枢神经系统白质改变的检出率有所增加。目的：研究既往无神经症状但MRI表现高度提示多发性硬化（MS）的患者的病情演变。
我们对11例MRI表现提示MS的患者进行了描述性研究。采用纵向随访来确定影像学进展以及是否转变为孤立性神经综合征和临床确诊的MS。
共纳入11例患者（7例女性，4例男性），平均年龄36岁（范围：28 - 48岁），这些患者因头痛（n = 2）、神经根痛（n = 3）、创伤性脑损伤（n = 1）、晕厥（n = 1）、周围神经病变（n = 1）和癫痫发作（n = 1）接受了MRI扫描。初次MRI扫描时Barkhof - Tintore标准的平均数量为3个。寡克隆带研究在6例中呈阳性，9例患者进行了视觉诱发电位检查（3例异常）。平均随访时间为2.9年（范围：2个月 - 11.9年）。初次和第二次MRI扫描之间的平均时间间隔为2.03年。7例出现影像学进展（其中5例有钆摄取）。5例成为孤立性神经综合征病例，自初次MRI扫描以来的平均时间为4.13年。其中，3例转变为临床确诊的MS，2例转变为复发缓解型（初次MRI扫描后平均8.54年），另1例转变为原发进展型。
识别高度提示MS的偶然病变有助于确定一组患MS风险增加的人群。
