Otsuka S, Nakatsu S, Matsumoto S, Sato S, Motozaki T, Ban S, Yamamoto T, Takatsuka K, Saiwai S
Department of Neurosurgery, Kobe City General Hospital, Japan.
J Comput Assist Tomogr. 1989 Jul-Aug;13(4):674-8. doi: 10.1097/00004728-198907000-00023.
A 44-year-old woman with multiple sclerosis (MS) stimulating a brain tumor on CT is reported. At the first hospitalization, a heterogeneously enhancing mass lesion with perifocal edema was identified on CT in the left parietal lobe. Biopsy of the lesion revealed necrotic change of the brain, gliosis, and perivascular cuffing; several months later no tumor cells were identified. The follow-up CT revealed reduction of the enhancing lesion and disappearance of the perifocal edema, with only a low density area persisting. At the second hospitalization, CT revealed a ring enhancing lesion with perifocal edema in the right temporoparietal region. Follow-up CT several months later revealed reduction of the lesion, with the residual of a small low density area. Magnetic resonance (MR) allowed us to identify multiple lesions in addition to those visualized on CT. In some cases of MS, the CT findings are very similar to those found in brain tumors. In these instances, MR is more useful in the diagnosis of MS than CT.
报道了一名44岁患有多发性硬化症（MS）的女性，其在CT上显示出类似脑肿瘤的情况。首次住院时，CT在左侧顶叶发现一个不均匀强化的肿块病变，伴有灶周水肿。病变活检显示脑坏死改变、胶质增生和血管周围套袖样改变；几个月后未发现肿瘤细胞。随访CT显示强化病变缩小，灶周水肿消失，仅遗留一个低密度区。第二次住院时，CT在右侧颞顶叶区域发现一个环形强化病变，伴有灶周水肿。几个月后的随访CT显示病变缩小，残留一个小的低密度区。磁共振成像（MR）使我们能够识别出除CT所见之外的多个病变。在某些MS病例中，CT表现与脑肿瘤非常相似。在这些情况下，MR在MS诊断中比CT更有用。
