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老年患者白质脱髓鞘的临床表现及影像学特征

Clinical manifestations and imaging features of white matter demyelination in older patients.

作者信息

Li Jian, Zhao Yi-Ming

机构信息

Department of Neurology, Peking University Third Hospital, Beijing, China.

Clinical Epidemiology Research Center, Peking University Third Hospital, Beijing, China.

出版信息

J Int Med Res. 2020 Nov;48(11):300060520966806. doi: 10.1177/0300060520966806.

Abstract

OBJECTIVE

To investigate the clinical manifestations and imaging features of older patients with white matter demyelination diagnosed by magnetic resonance imaging (MRI).

METHODS

Ninety-six patients with leukoaraiosis diagnosed by MRI were divided by their clinical diagnoses into a demyelinating group (40 cases) and a non-demyelinating group (56 cases). The imaging and clinical features of the patients in the two groups were analyzed.

RESULTS

Compared with the non-demyelinating group, there were significantly more women in the demyelinating group than men. There was no significant difference in age between the two groups. Of the 37 cases who had an imaging report of "white matter demyelination and multiple sclerosis," 36 cases had a clinical diagnosis in accordance with white matter demyelination (97.3%). Of the 59 cases who had an imaging report of "white matter demyelination", only four cases had a clinical diagnosis in accordance with demyelination (6.8%).

CONCLUSION

In older patients with headaches, vertigo, other head symptoms, and unilateral numbness as the chief complaints, a clinical diagnosis of demyelinating disease is very unlikely when the imaging report states white matter demyelination only.

摘要

目的

探讨磁共振成像(MRI)诊断的老年白质脱髓鞘患者的临床表现及影像学特征。

方法

将96例经MRI诊断为脑白质疏松症的患者按临床诊断分为脱髓鞘组(40例)和非脱髓鞘组(56例)。分析两组患者的影像学及临床特征。

结果

与非脱髓鞘组相比,脱髓鞘组女性明显多于男性。两组年龄无显著差异。在37例影像学报告为“白质脱髓鞘和多发性硬化”的病例中,36例临床诊断符合白质脱髓鞘(97.3%)。在59例影像学报告为“白质脱髓鞘”的病例中,只有4例临床诊断符合脱髓鞘(6.8%)。

结论

以头痛、眩晕、其他头部症状及单侧麻木为主诉的老年患者,若影像学报告仅提示白质脱髓鞘,则临床诊断为脱髓鞘疾病的可能性极小。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a5f1/7653294/d0bb96953aa5/10.1177_0300060520966806-fig1.jpg

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