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磁共振成像在运动神经元病诊断中的作用:文献综述与两个病例说明

Role of Magnetic Resonance Imaging in Diagnosis of Motor Neuron Disease: Literature Review and Two Case Illustrations.

作者信息

Sawalha Khalid, Gonzalez-Toledo Eduardo, Hussein Omar

机构信息

Department of Internal Medicine, University of Massachusetts Medical School-Baystate Medical Center, Springfield.

Neuroradiology Division, Louisiana State University Health Sciences Center, Shreveport.

出版信息

Perm J. 2019;23. doi: 10.7812/TPP/18-131.

Abstract

Motor neuron diseases (MNDs) are a group of devastating neurologic disorders that cause specific damage to the motor neuron cells. The current diagnosis of MND is based on results of the clinical examination and neurophysiologic studies. The length of time of referral to a neuromuscular neurologist and the lack of validated diagnostic criteria can delay diagnosis. Although the role of imaging is currently most useful in excluding other conditions, several attempts to incorporate neuroimaging in the diagnosis of the disease and assessment of progression have shown promising results.We conducted a literature review via searches in PubMed and The Cochrane Database using multiple relevant terms to the topic. Two cases with a challenging diagnosis of MND are described, with a thorough discussion of how the diagnosis was suggested on the basis of magnetic resonance imaging evidence in each case. Advanced magnetic resonance imaging findings can be useful tools that add to the diagnostic criteria of MNDs, especially in cases where reaching a definitive diagnosis is difficult. Such findings might enable clinicians to reach an early diagnosis that can improve the patient's quality of life and prolong survival.

摘要

运动神经元病(MNDs)是一组毁灭性的神经系统疾病,会对运动神经元细胞造成特定损害。目前MND的诊断基于临床检查和神经生理学研究结果。转诊至神经肌肉神经科医生的时间长度以及缺乏经过验证的诊断标准会延迟诊断。尽管目前影像学在排除其他疾病方面最有用,但将神经影像学纳入该疾病诊断和病情进展评估的几次尝试已显示出有前景的结果。我们通过在PubMed和考克兰数据库中使用与该主题相关的多个术语进行检索,开展了一项文献综述。描述了两例诊断具有挑战性的MND病例,并深入讨论了在每个病例中如何根据磁共振成像证据做出诊断。先进的磁共振成像结果可能是有助于MND诊断标准的有用工具,尤其是在难以做出明确诊断的病例中。这些结果可能使临床医生能够做出早期诊断,从而改善患者的生活质量并延长生存期。

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