Gebarski S S, Gabrielsen T O, Gilman S, Knake J E, Latack J T, Aisen A M
Ann Neurol. 1985 May;17(5):469-74. doi: 10.1002/ana.410170509.
Thirty patients in whom the initial diagnosis of multiple sclerosis was clinically entertained underwent cranial magnetic resonance imaging (MRI) in close temporal relationship to cranial x-ray computed tomography (CT), electrodiagnostic studies (visual evoked responses, brainstem auditory evoked responses, and somatosensory evoked responses), and cerebrospinal fluid analyses (oligoclonal bands, myelin basic protein, and IgG/albumin ratio). In 26 of the 30 patients, MRI demonstrated lesions consistent with multiple sclerosis that corresponded, at least in part, with the clinically expected neuroanatomical lesion distribution. Two of the 4 patients with normal MRI had normal electrodiagnostic studies and cerebrospinal fluid analyses, and the other 2 had a single abnormal or equivocal electrodiagnostic study. All 26 patients with abnormal MRI had at least one other abnormal laboratory test. CT revealed only the largest lesions, and in the patients with abnormal CT, MRI demonstrated even more lesions. MRI, in this limited series, proved to be a strong tool in the initial diagnosis of multiple sclerosis; it may prove to be the single best test, with a sensitivity exceeding that of electrodiagnostic studies and cerebrospinal fluid analysis.
30例临床上初步考虑为多发性硬化症的患者在与头颅X线计算机断层扫描（CT）、电诊断研究（视觉诱发电位、脑干听觉诱发电位和体感诱发电位）以及脑脊液分析（寡克隆带、髓鞘碱性蛋白和IgG/白蛋白比值）密切的时间关系内接受了头颅磁共振成像（MRI）检查。在这30例患者中的26例中，MRI显示出与多发性硬化症相符的病变，这些病变至少部分与临床上预期的神经解剖学病变分布相对应。MRI正常的4例患者中，2例电诊断研究和脑脊液分析正常，另外2例有一项电诊断研究异常或结果不明确。所有26例MRI异常的患者至少还有一项其他实验室检查异常。CT仅显示了最大的病变，在CT异常的患者中，MRI显示出更多的病变。在这个有限的系列研究中，MRI被证明是多发性硬化症初步诊断的有力工具；它可能被证明是单一的最佳检查，其敏感性超过电诊断研究和脑脊液分析。
