Kojima S, Hirayama K, Kakisu Y, Adachi E
Department of Neurology, School of Medicine, Chiba University, Japan.
No To Shinkei. 1990 Dec;42(12):1191-5.
Magnetic resonance imaging (MRI) of the optic nerves was performed in 10 patients with multiple sclerosis (MS) using short inversion time inversion recovery (STIR) pulse sequences, and the results were compared with the visual evoked potentials (VEP). The 10 patients had optic neuritis in the chronic or remitting phase together with additional symptoms or signs allowing a diagnosis of clinically definite or probable MS. Sixteen optic nerves were clinically affected and 4 were unaffected. MRI was performed using a 0.5 tesla superconducting unit, and multiple continuous 5 mm coronal and axial STIR images were obtained. A lesion was judged to be present if a focal or diffuse area of increased signal intensity was detected in the optic nerve. In VEP, a delay in peak latency or no P 100 component was judged to be abnormal. With regard to the clinically affected optic nerves, MRI revealed a region of increased signal intensity in 14/16 (88%) and the VEP was abnormal in 16/16 (100%). In the clinically unaffected optic nerves, MRI revealed an increased signal intensity in 2/4 (50%). One of these nerves had an abnormal VEP and the other had a VEP latency at the upper limit of normal. The VEP was abnormal in 1/4 (25%). In the clinically affected optic nerves, the degree of loss of visual acuity was not associated with the longitudinal extent of the lesions shown by MRI. The mean length was 17.5 mm in optic nerves with a slight disturbance of visual acuity and 15.0 mm in nerves with severe visual loss.(ABSTRACT TRUNCATED AT 250 WORDS)
对10例多发性硬化症(MS)患者使用短反转时间反转恢复(STIR)脉冲序列进行视神经磁共振成像(MRI)检查,并将结果与视觉诱发电位(VEP)进行比较。这10例患者处于慢性期或缓解期视神经炎,伴有其他症状或体征,可诊断为临床确诊或可能的MS。16条视神经有临床受累,4条未受累。使用0.5特斯拉超导装置进行MRI检查,获得多个连续的5毫米冠状位和轴位STIR图像。如果在视神经中检测到信号强度增加的局灶性或弥漫性区域,则判断存在病变。在VEP中,峰值潜伏期延迟或无P100成分被判断为异常。对于临床受累的视神经,MRI显示14/16(88%)有信号强度增加区域,VEP异常的为16/16(100%)。在临床未受累的视神经中,MRI显示2/4(50%)有信号强度增加。其中一条神经VEP异常,另一条神经VEP潜伏期处于正常上限。VEP异常的为1/4(25%)。在临床受累的视神经中,视力丧失程度与MRI所示病变的纵向范围无关。视力轻度受损的视神经平均长度为17.5毫米,严重视力丧失的视神经平均长度为15.0毫米。(摘要截取自250字)