Baum K, Junge M, Felix R
Abteilung für Neurologie der Psychiatrischen, Universitätsklinikum Rudolf Virchow, Freien Universität Berlin.
Nervenarzt. 1994 Aug;65(8):542-8.
Clinicotopographic correlations were performed in a larger group of patients with multiple sclerosis (n = 121). In the assessment of two raters working independently from one another, 73% of all clinical brainstem findings (n = 74) could be traced back to demyelination plaques in the supposed localization as visualized by MRI. The clinical topodiagnostic was especially in accordance with MRI findings concerning internuclear ophthalmoplegia (85%) and abducens palsy (79%). Cerebellar dysfunctions (n = 60) correlated with morphological findings in 87%. More than half of all patients with cerebellar and brainstem symptoms exhibited a periventricular demyelination around the 4th ventricle which was associated with the clinical topodiagnostic. Unequivocal MRI correlations could be hardly found for clinical findings of low topodiagnostical value (symptoms of the long motor and sensory pathways). The clinical status as expressed by Kurtzke's EDSS reflects the extent of cerebral demyelination as seen by MRI only in a larger patient group.
在一大组多发性硬化症患者（n = 121）中进行了临床-地形学相关性研究。在对两名彼此独立工作的评估者的评估中，所有临床脑干发现（n = 74）中有73%可追溯到MRI显示的假定定位处的脱髓鞘斑块。临床拓扑诊断尤其与关于核间性眼肌麻痹（85%）和展神经麻痹（79%）的MRI结果一致。小脑功能障碍（n = 60）与形态学发现的相关性为87%。所有有小脑和脑干症状的患者中，超过一半在第四脑室周围表现出脑室周围脱髓鞘，这与临床拓扑诊断相关。对于拓扑诊断价值较低的临床发现（长运动和感觉通路症状），很难找到明确的MRI相关性。库尔茨克扩展残疾状态量表（EDSS）所反映的临床状态仅在更大的患者群体中反映出MRI所见的脑脱髓鞘程度。
