Cheung G, Gawel M J, Cooper P W, Farb R I, Ang L C, Gawal M J
Department of Neuroradiology, Sunnybrook Health Science Centre, North York, Ontario, Canada.
Radiology. 1995 Jan;194(1):263-70. doi: 10.1148/radiology.194.1.7997565.
To determine the magnetic resonance (MR) imaging characteristics of amyotrophic lateral sclerosis (ALS) and to evaluate possible correlations between the disease severity and the MR imaging findings.
The authors retrospectively reviewed MR images of the head in 17 patients with ALS (14 men and three women) and 17 age-matched control subjects. The corticospinal tract (CST) was analyzed for the following features: size, signal intensity, and number of sections and regions in which the CST could be seen.
Patients with ALS demonstrated sharp, well-defined, round, symmetric lesions that were hyperintense to gray matter within the CST. The lesions were best seen at the level of the middle or lower internal capsule on T2-weighted images. Visualization of the CST on proton-density-weighted images (which occurred in eight ALS patients) is the most reliable MR finding. Low signal intensity was identified within the motor cortex in six patients. Positive MR findings correlated with average or rapid progression of the disease.
Increased signal intensity in the CST on proton-density-weighted MR images is diagnostic for motor neuron disease and correlates with the rate of disease progression. Subtle ALS changes can be differentiated from the normal CST. Low signal intensity in the motor cortex on T2-weighted images is a useful finding.
确定肌萎缩侧索硬化症（ALS）的磁共振（MR）成像特征，并评估疾病严重程度与MR成像结果之间的可能相关性。
作者回顾性分析了17例ALS患者（14例男性和3例女性）及17例年龄匹配的对照者的头部MR图像。对皮质脊髓束（CST）分析以下特征：大小、信号强度以及能看到CST的节段数和区域。
ALS患者显示出尖锐、边界清晰、圆形、对称的病灶，在CST内相对于灰质呈高信号。这些病灶在T2加权图像上在内囊中部或下部水平最易显示。质子密度加权图像上CST的显示（8例ALS患者出现）是最可靠的MR表现。6例患者的运动皮质内发现低信号强度。MR阳性结果与疾病的平均或快速进展相关。
质子密度加权MR图像上CST信号强度增加对运动神经元病具有诊断意义，且与疾病进展速度相关。ALS的细微变化可与正常CST区分开来。T2加权图像上运动皮质的低信号强度是一个有用的表现。
