Moriwaka F, Kishihara T, Matsumoto A, Hamada T, Tashiro K, Miyasaka K
No To Shinkei. 1980 Aug;32(8):761-7.
Recent introduction of Computed Tomography (CT) in clinical neurology made it possible to visualize the brain lesion without any invasive procedures. In multiple sclerosis (MS), the demyelinating foci were reported to be observed as low density areas on CT, but occasionally contrast enhanced high density areas were reported also. So far as we know, only a few reports which analysed interrelationship between clinical signs and CT findings were published. In this report we tried to examine the correlation of clinical findings with CT in MS. All scans were performed using an EMI head scanner (EMI 1000) with a 160 X 160 matrix. Contrast material was administered as an intravenous bolus of 60% meglumine iothalamate. In clinically definite 14 MS patients, CT showed localized, circumscribed low density areas in 4 patients, periventricular low density in 1 patient, widening of cortical sulci with ventricular dilatation in 11 patients and no abnormalities in 3 patients. The widening of cortical sulci with ventricular dilatation were noted to be particularly common findings. The periventricular low density was not so frequently seen as we expected. Localized, circumscribed low density areas on CT were well correlated with the neurological findings in 2 patients. In these cases the abnormalities on CT persisted in spite of neurological improvement. As a conclusion, we think CT might be useful as a diagnostic evaluation of MS.
计算机断层扫描(CT)最近在临床神经病学中的应用使得在无需任何侵入性操作的情况下可视化脑病变成为可能。在多发性硬化症(MS)中,据报道脱髓鞘病灶在CT上表现为低密度区域,但偶尔也有报道称出现对比增强的高密度区域。据我们所知,仅发表了少数分析临床体征与CT表现之间相互关系的报告。在本报告中,我们试图研究MS患者临床 findings与CT之间的相关性。所有扫描均使用带有160×160矩阵的EMI头部扫描仪(EMI 1000)进行。造影剂以60%碘肽葡胺静脉推注的方式给药。在14例临床确诊的MS患者中,CT显示4例患者有局限性、边界清晰的低密度区域,1例患者有脑室周围低密度,11例患者有皮质沟增宽伴脑室扩张,3例患者无异常。皮质沟增宽伴脑室扩张被认为是特别常见的表现。脑室周围低密度并不像我们预期的那样频繁出现。CT上局限性、边界清晰的低密度区域与2例患者的神经学表现密切相关。在这些病例中,尽管神经功能有所改善,但CT上的异常仍然存在。作为结论,我们认为CT可能对MS的诊断评估有用。