Nesbit G M, Forbes G S, Scheithauer B W, Okazaki H, Rodriguez M
Department of Diagnostic Radiology, Mayo Clinic, Rochester, MN 55905.
Radiology. 1991 Aug;180(2):467-74. doi: 10.1148/radiology.180.2.2068314.
The authors retrospectively reviewed the cases of 40 patients with biopsy- or autopsy-proved inflammatory demyelination consistent with multiple sclerosis (MS); each patient underwent magnetic resonance (MR) and/or computed tomographic (CT) imaging. In review of the 32 MR and 30 CT examinations, three predominant radiologic patterns were apparent: (a) relatively small homogeneous lesions with no or minimal diffuse enhancement; (b) hypoattenuating lesions on CT scans and hypointense lesions on short-TR MR images, with a contrast material-enhanced, isoattenuating or isointense ring; and (c) lesions that were more infiltrative and ill defined, with mixed attenuation and signal intensity and scattered enhancement. A common radiologic feature was lack of mass effect or edema in white matter surrounding even large lesions. In all but four patients the lesions were classified as active by using both histologic and clinical criteria. Histologically active lesions had various radiologic appearances; however, in all contrast-enhanced studies they demonstrated some form of enhancement. Inactive lesions were homogeneously hypoattenuating on CT scans, hypointense on short-TR MR images, and hyperintense on unenhanced, long-TR MR images.
作者回顾性分析了40例经活检或尸检证实为符合多发性硬化（MS）的炎性脱髓鞘病例；每位患者均接受了磁共振（MR）和/或计算机断层扫描（CT）成像检查。在对32例MR检查和30例CT检查的回顾中，出现了三种主要的放射学表现：（a）相对较小的均匀病灶，无或仅有轻微弥漫性强化；（b）CT扫描上呈低密度灶，短TR MR图像上呈低信号灶，有对比剂强化的等密度或等信号环；（c）病灶浸润性更强、边界不清，有混合密度和信号强度及散在强化。一个常见的放射学特征是，即使是大病灶，其周围白质也无占位效应或水肿。除4例患者外，所有患者的病灶根据组织学和临床标准均被分类为活动期。组织学上的活动期病灶有多种放射学表现；然而，在所有增强研究中，它们均表现出某种形式的强化。非活动期病灶在CT扫描上呈均匀低密度，在短TR MR图像上呈低信号，在未增强的长TR MR图像上呈高信号。
