Bag A K, Patel B N, Osman S, Roberson G H
Department of Radiology, University of Alabama; Birmingham, AL, USA -
Neuroradiol J. 2011 Aug 31;24(4):511-8. doi: 10.1177/197140091102400405. Epub 2011 Sep 2.
MRI is extremely useful for the assessment of initial disease burden and to identify the dissemination of the multiple sclerosis (MS) in time and space. Though MRI of the spinal cord is not used to establish the diagnosis of MS, spinal cord is frequently involved in this disease and there has been increasing emphasis of the spinal imaging in making clinical decision in the management of MS. We undertook a retrospective study of patients with diagnosed MS: 1) to identify radiologic pattern of spinal cord involvement in MS and 2) to correlate radiologic findings with clinical presentation. We reviewed radiologic records from 2004 to 2009 of patients with abnormal T2 signal intensity of the spinal cord with radiologic concern of demyelinating disease. Patients in this cohort who met the Revised McDonald MS Diagnostic Criteria were included in this study. 166 patients were included in the study. There was preference for cervical spinal cord particularly posterior aspect of the spinal cord. Enhancement of the lesions was rare (4.1%). Mean lesion length was 18.2 mm. The average number of lesions per patient was 2.04. Sensory symptoms were predominating and most of the patients had relapsing-remitting course. Patients with sensory symptoms, bladder and bowel involvement and motor symptoms had almost equally distributed lesions among anterior, posterior and central spinal cord. However, all of the patients presented with posterior column signs and gait abnormality had involvement of the posterior spinal cord. Radiologic manifestation of spinal cord MS is extremely variable and can involve the entire length of the spinal cord. Clinical symptoms may or may not be associated with radiologic presentation of the lesions.
磁共振成像（MRI）对于评估初始疾病负担以及及时识别多发性硬化症（MS）在时间和空间上的扩散极为有用。虽然脊髓MRI并非用于确诊MS，但脊髓在该疾病中常受累，并且在MS治疗的临床决策中，脊髓成像的重要性日益凸显。我们对确诊为MS的患者进行了一项回顾性研究：1）确定MS中脊髓受累的放射学模式；2）将放射学表现与临床表现相关联。我们回顾了2004年至2009年脊髓T2信号强度异常且放射学怀疑为脱髓鞘疾病患者的放射学记录。该队列中符合修订的麦克唐纳MS诊断标准的患者纳入本研究。166名患者纳入研究。脊髓受累部位以颈髓尤其是脊髓后侧为主。病变强化少见（4.1%）。平均病变长度为18.2毫米。每位患者的平均病变数为2.04个。感觉症状为主，大多数患者病程为复发缓解型。有感觉症状、膀胱和肠道受累及运动症状的患者，其病变在前、后及中央脊髓的分布大致相同。然而，所有出现后柱体征和步态异常的患者均有脊髓后侧受累。脊髓型MS的放射学表现极为多样，可累及脊髓全长。临床症状可能与病变的放射学表现相关，也可能无关。
