Cutler J R, Aminoff M J, Brant-Zawadzki M
Ann Neurol. 1986 Nov;20(5):645-8. doi: 10.1002/ana.410200518.
We compared the diagnostic usefulness of evoked potential (EP) studies and magnetic resonance imaging (MRI) in the evaluation of 27 patients with definite or probable multiple sclerosis (MS). MRI scans demonstrated multiple lesions in 21 patients whereas EP studies showed multiple abnormalities in 14 patients (4 of whom had only somatosensory EP abnormalities). Eighteen patients had similar MRI and EP results (e.g., normal or multiple abnormalities), 8 had multiple abnormalities shown by MRI but normal or single-modality abnormal EPs, and 1 had multiple abnormal EPs but a normal MRI scan. There was no significant difference in the sensitivity of the two techniques in detecting multiple lesions in the patients with definite MS, whereas among those with probable MS, MRI had a significantly higher yield. Seventeen patients showed clinical evidence of posterior fossa involvement, 6 patients had abnormal brainstem auditory evoked potentials (BAEPs), and 4 patients had areas of increased signal intensity revealed by MRI of the brainstem. There was no clinical evidence of brainstem involvement in 2 patients with BAEP abnormalities, 2 with an abnormal posterior fossa shown by MRI, and one patient with abnormalities shown by both BAEP and MRI. We conclude that MRI is more sensitive in detecting multiple lesions than are multimodality EP studies, but that BAEP assessment may be slightly more sensitive than MRI in detecting brainstem lesions.
我们比较了诱发电位（EP）研究和磁共振成像（MRI）在评估27例明确或可能患有多发性硬化症（MS）患者中的诊断效用。MRI扫描显示21例患者有多个病灶，而EP研究显示14例患者有多个异常（其中4例仅体感EP异常）。18例患者的MRI和EP结果相似（例如，正常或多个异常），8例患者MRI显示多个异常但EP正常或单模态异常，1例患者有多个异常EP但MRI扫描正常。在明确患有MS的患者中，两种技术检测多个病灶的敏感性没有显著差异，而在可能患有MS的患者中，MRI的检出率显著更高。17例患者有后颅窝受累的临床证据，6例患者脑干听觉诱发电位（BAEP）异常，4例患者脑干MRI显示信号强度增加区域。2例BAEP异常患者、2例MRI显示后颅窝异常患者以及1例BAEP和MRI均异常的患者没有脑干受累的临床证据。我们得出结论，在检测多个病灶方面，MRI比多模态EP研究更敏感，但在检测脑干病灶方面，BAEP评估可能比MRI稍敏感。
