Adesina Ore-Ofe O, Scott McNally J, Salzman Karen L, Katz Bradley J, Warner Judith E A, McFadden Molly, Digre Kathleen B
Moran Eye Center, Department of Ophthalmology and Visual Sciences, The University of Utah, Salt Lake City, Utah, USA.
Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, Texas, USA.
Neuroophthalmology. 2017 Aug 18;42(2):90-98. doi: 10.1080/01658107.2017.1356856. eCollection 2018 Apr.
Non-arteritic anterior ischaemic optic neuropathy (NAION) and optic neuritis (ON) may be difficult to distinguish early in their disease courses. Our goal was to determine if specific magnetic resonance imaging characteristics differentiate acute NAION from ON. Neuroradiologists, masked to diagnosis, reviewed the diffusion-weighted imaging (DWI) and post-contrast enhancement (PCE) characteristics of the optic nerve in 140 eyes. PCE and DWI signals of the optic disc alone did not discriminate between NAION and ON. After taking age and sex into consideration, only DWI and PCE of the intraorbital segment of the optic nerve differentiated the two, with ON having the increased likelihood of these findings. Isolated PCE without DWI signal at the optic disc, however, was 100% specific for NAION. This may be the most specific way to radiographically differentiate between NAION and ON in the acute setting.
非动脉炎性前部缺血性视神经病变（NAION）和视神经炎（ON）在疾病病程早期可能难以区分。我们的目标是确定特定的磁共振成像特征是否能区分急性NAION和ON。对诊断不知情的神经放射科医生回顾了140只眼中视神经的弥散加权成像（DWI）和增强后强化（PCE）特征。仅视盘的PCE和DWI信号无法区分NAION和ON。在考虑年龄和性别因素后，仅视神经眶内段的DWI和PCE能够区分二者，ON出现这些表现的可能性更高。然而，视盘处孤立的PCE而无DWI信号对NAION具有100%的特异性。这可能是在急性情况下通过影像学区分NAION和ON的最具特异性的方法。
