Campi A, Filippi M, Comi G, Martinelli V, Baratti C, Rovaris M, Scotti G
Neuroradiological Department, Scientific Institute HS Raffaele, University of Milan, Italy.
AJNR Am J Neuroradiol. 1995 Jan;16(1):115-23.
To evaluate the contribution of MR in determining the cause of acute transverse myelopathy, to determine the frequency and types of the intracranial lesions detectable on MR at the onset of the disease, and to monitor clinical and MR evolution of the disease.
Spinal and cranial MR images were obtained for 30 patients with acute transverse myelopathy. Gadopentetate dimeglumine was administered in 10 patients. Mean follow-up time was 18 months.
Spinal cord MR findings were abnormal in 14 of 30 patients. The abnormal MR can be divided into group A, in which one segment was involved (8 patients), and group B, in which more than one segment was involved (6 patients). In both groups there were 2 patients with enhancing lesions. Enhancement was less homogeneous in the group B patients. Enhancement did not change with increased length of lesion. At follow-up, the diagnostic categories of the patients were multiple sclerosis (8 patients), encephalomyelitis (1 patient), viral myelitis (3 patients), and myelopathy of unknown cause (18 patients). After the episode of acute transverse myelopathy, in 4 of 8 patients in group A and in 4 of 5 patients with normal spinal MR but abnormal brain MR findings clinical signs of multiple sclerosis developed. In no patients in group B did multiple sclerosis develop. The final diagnoses for the 4 patients with gadolinium-enhancing spinal lesions were myelopathy of unknown cause (2 patients), multiple sclerosis (1 patient), and viral myelitis (1 patient).
MR contributed to establishing the diagnosis in 40% of our cases.
评估磁共振成像（MR）在确定急性横贯性脊髓炎病因方面的作用，确定疾病发作时MR可检测到的颅内病变的频率和类型，并监测疾病的临床和MR演变情况。
对30例急性横贯性脊髓炎患者进行了脊髓和颅脑MR成像检查。10例患者使用了钆喷酸葡胺。平均随访时间为18个月。
30例患者中14例脊髓MR表现异常。异常MR可分为A组（1个节段受累，8例患者）和B组（1个以上节段受累，6例患者）。两组均有2例患者出现强化病变。B组患者强化的均匀性较差。强化程度不随病变长度增加而改变。随访时，患者的诊断分类为多发性硬化（8例）、脑脊髓炎（1例）、病毒性脊髓炎（3例）和病因不明的脊髓病（18例）。在急性横贯性脊髓炎发作后，A组8例患者中的4例以及脊髓MR正常但脑部MR表现异常的5例患者中的4例出现了多发性硬化的临床体征。B组患者均未发生多发性硬化。4例钆增强脊髓病变患者的最终诊断为病因不明的脊髓病（2例）、多发性硬化（1例）和病毒性脊髓炎（1例）。
MR在我们40%的病例中有助于确立诊断。
