Department of Neurology, Mayo Clinic, Rochester, MN, USA.
Division of Neuroradiology, Department of Radiology, Mayo Clinic, Rochester, MN, USA.
Mult Scler. 2021 Feb;27(2):303-308. doi: 10.1177/1352458520907900. Epub 2020 Feb 27.
Myelitis accompanied by a negative spinal cord MRI may lead to diagnostic uncertainty.
We retrospectively investigated the frequency of negative spinal cord MRI (performed <6 weeks from onset) in Mayo Clinic patients with myelin oligodendrocyte glycoprotein (MOG)-IgG-associated myelitis (2000-2019).
The initial spinal cord MRI was negative in 7/73 (10%) patients, despite severe acute disability (median EDSS, 7 (range, 4.5-8)); myelitis symptoms/signs were frequent (paraparesis, neurogenic bladder, sensory level, Lhermitte's phenomenon). Myelitis lesions became overt at follow-up MRI in three patients.
A negative spinal cord MRI should not dissuade from MOG-IgG testing in patients with acute/subacute myelitis.
脊髓炎伴阴性脊髓 MRI 可能导致诊断不确定。
我们回顾性调查了 Mayo 诊所 2000 年至 2019 年间患有髓鞘少突胶质细胞糖蛋白（MOG）-IgG 相关脊髓炎的患者中（发病后<6 周）阴性脊髓 MRI 的频率。
尽管存在严重的急性残疾（中位 EDSS，7（范围，4.5-8）），但 73 例患者中有 7 例（10%）的初始脊髓 MRI 为阴性；脊髓炎症状/体征常见（截瘫、神经性膀胱、感觉水平、Lhermitte 现象）。在三名患者中，随访 MRI 时出现明显的脊髓炎病变。
对于急性/亚急性脊髓炎患者，阴性脊髓 MRI 不应阻止 MOG-IgG 检测。
