Comparative brain stem lesions on MRI of acute disseminated encephalomyelitis, neuromyelitis optica, and multiple sclerosis.
Comparative brain stem lesions on MRI of acute disseminated encephalomyelitis, neuromyelitis optica, and multiple sclerosis.
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DOI：
10.1371/journal.pone.0022766
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发表时间：
2011
期刊：
影响因子：
3.7
通讯作者：
Hu X
中科院分区：
文献类型：
--
作者：
Lu Z;Zhang B;Qiu W;Kang Z;Shen L;Long Y;Huang J;Hu X
脑干病变常见于急性播散性脑脊髓炎(ADEM)、视神经脊髓炎(NMO)和多发性硬化症(MS)患者。为探讨成人ADEM、NMO和MS患者脑干病变的MRI表现，对65例成人ADEM患者(n = 17例)、NMO患者(n = 23例)和MS患者(n = 25例)的脑干病变进行了研究。对这些疾病的脑干病变的形态特征进行了评价。ADEM患者中脑损害的发生率高于正常对照组(94.1%vs.17.4%，P&t；0.001)和多发性硬化症(94.1%vs.40.0%，P<；0.001)，桥脑损害发生率低于多发性硬化(34.8%vs.84.0%，P<；0.001)和多发性硬化症(34.8%vs.70.6%，P& = 0.025)；NMO患者延髓病变的发生率高于ADEM患者(91.3%vs.35.3%，P<；0.001)和MS患者(91.3%vs.36.0%，P<；0.001)。ADEM患者脑干轴位病变多位于腹侧(82.4%)，NMO患者脑干病变多位于背侧(91.3%)，MS患者病变同时位于腹侧(44.0%)和背侧(56.0%)。ADEM(100%)和NMO(91.3%)患者的病灶边界不清，而MS患者(76.0%)的病灶边缘清晰。ADEM患者的脑干病变多为双侧对称性(82.4%)，而NMO(87.0%)和MS(92.0%)患者的病变多为不对称或单侧。成人ADEM、NMO和MS患者的脑干病变表现出不同的形态特征，不同的病变部位可能有助于这些疾病的鉴别。
Brain stem lesions are common in patients with acute disseminated encephalomyelitis (ADEM), neuromyelitis optica (NMO), and multiple sclerosis (MS). To investigate comparative brain stem lesions on magnetic resonance imaging (MRI) among adult patients with ADEM, NMO, and MS. Sixty-five adult patients with ADEM (n = 17), NMO (n = 23), and MS (n = 25) who had brain stem lesions on MRI were enrolled. Morphological features of brain stem lesions among these diseases were assessed. Patients with ADEM had a higher frequency of midbrain lesions than did patients with NMO (94.1% vs. 17.4%, P<0.001) and MS (94.1% vs. 40.0%, P<0.001); patients with NMO had a lower frequency of pons lesions than did patients with MS (34.8% vs. 84.0%, P<0.001) and ADEM (34.8% vs. 70.6%, P = 0.025); and patients with NMO had a higher frequency of medulla oblongata lesions than did patients with ADEM (91.3% vs. 35.3%, P<0.001) and MS (91.3% vs. 36.0%, P<0.001). On the axial section of the brain stem, the majority (82.4%) of patients with ADEM showed lesions on the ventral part; the brain stem lesions in patients with NMO were typically located in the dorsal part (91.3%); and lesions in patients with MS were found in both the ventral (44.0%) and dorsal (56.0%) parts. The lesions in patients with ADEM (100%) and NMO (91.3%) had poorly defined margins, while lesions of patients with MS (76.0%) had well defined margins. Brain stem lesions in patients with ADEM were usually bilateral and symmetrical (82.4%), while lesions in patients with NMO (87.0%) and MS (92.0%) were asymmetrical or unilateral. Brain stem lesions showed various morphological features among adult patients with ADEM, NMO, and MS. The different lesion locations may be helpful in distinguishing these diseases.
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