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目的探讨脊髓型多发性硬化(multiple sclerosis,MS)的MRI表现,评价MRI对脊髓型MS的诊断价值。方法搜集临床确诊的脊髓型MS17例,男6例,女11例,年龄20～63岁,平均(33±9.6)岁,均行脊柱和头颅MRI平扫及增强扫描,对其临床及MRI资料进行回顾性分析。结果本组脊髓单发病变7例,多发病变10例。病变累及颈段脊髓9例,占52.9%(9/17);胸段脊髓4例,占23.5%(4/17);同时累及颈胸段脊髓4例,占23.5%(4/17);合并脑部MS8例。病变呈斑片状、长条状,均不同程度累及脊髓灰白质;矢状面病变长轴与脊髓平行,范围1～5个椎体高度,其中11例大于2个椎体高度;T1WI呈低信号3例,等信号14例;T2WI均表现为高信号;10例病变节段脊髓轻度增粗。增强扫描11例表现为斑片状强化、边缘强化。结论脊髓型MS具有一定的MRI特征,MRI是诊断脊髓型MS的有效方法。
Objective To investigate the MRI manifestations of multiple sclerosis (MS) in spinal cord and to evaluate the diagnostic value of MRI in diagnosing spinal cord MS. Methods A total of 17 cases of clinically diagnosed spinal cord MS were collected, including 6 males and 11 females, aged from 20 to 63 years (average, 33 ± 9.6 years). All patients underwent plain and enhanced MRI of the spine and skull. Retrospective analysis. Results The group of single spinal cord disease in 7 cases, multiple lesions in 10 cases. There were 9 cases (52.9%) of the cervical spinal cord involved in the lesion, 4 cases (23.5%) of the thoracic spinal cord (4/17), and 4 cases (23.5%) of the cervical spinal cord. Combined brain MS8 cases. The lesions were patchy, elongated, varying degrees of involvement of the spinal cord gray matter; sagittal long axis of the spinal cord parallel to the range of 1 to 5 vertebral height, of which 11 were greater than 2 vertebral height; T1WI was low 3 cases of signal, 14 cases of equal signal; T2WI showed high signal; 10 cases of spinal cord mild thickening. Enhanced scanning in 11 cases showed patchy enhancement, edge enhancement. Conclusion Spinal cord MS has some MRI features and MRI is an effective method to diagnose spinal cord MS.