Razek Ahmed Abdel Khalek Abdel, Elsebaie Nermeen A
From the Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura.
Department of Radiology, Alexandria Faculty of Medicine, Alexandria, Egypt.
J Comput Assist Tomogr. 2020 Mar/Apr;44(2):248-254. doi: 10.1097/RCT.0000000000000997.
We aim to review the imaging appearance of fulminant demyelinating disorders of central nervous system that have different pathological features, clinical course, clinical features, and imaging findings different from classic multiple sclerosis. Routine magnetic resonance imaging (MRI) can help in accurate localization of the lesions, detection of associated lesions, and monitoring of these patients. Advanced MRI combined with routine MRI can aid in differentiation fulminant demyelinating lesions from simulating malignancy. Tumefactive demyelination lesions are located in supratentorial white matter mainly frontal and parietal regions with incomplete rim enhancement. Baló concentric sclerosis shows characteristic concentric onion skin appearance. Schilder disease is subacute or acute demyelinating disorders with one or more lesions commonly involving the centrum semiovale. Marburg disease is the most severe demyelinating disorder with diffuse infiltrative lesions and massive edema involving both the cerebral hemisphere and brain stem.
我们旨在回顾中枢神经系统暴发性脱髓鞘疾病的影像学表现，这些疾病具有不同的病理特征、临床病程、临床特征以及与经典多发性硬化不同的影像学表现。常规磁共振成像（MRI）有助于病变的准确定位、相关病变的检测以及对这些患者的监测。先进的MRI与常规MRI相结合有助于将暴发性脱髓鞘病变与模拟恶性肿瘤相鉴别。瘤样脱髓鞘病变主要位于幕上白质，以额叶和顶叶区域为主，边缘强化不完全。巴洛同心性硬化表现出特征性的同心洋葱皮样外观。席尔德病是亚急性或急性脱髓鞘疾病，有一个或多个病变，通常累及半卵圆中心。马尔堡病是最严重的脱髓鞘疾病，有弥漫性浸润性病变和累及大脑半球及脑干的大量水肿。
