THE INITIAL DIAGNOSIS OF MULTIPLE-SCLEROSIS - CLINICAL IMPACT OF MAGNETIC-RESONANCE IMAGING
THE INITIAL DIAGNOSIS OF MULTIPLE-SCLEROSIS - CLINICAL IMPACT OF MAGNETIC-RESONANCE IMAGING
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DOI：
10.1002/ana.410170509
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发表时间：
1985-01-01
影响因子：
11.2
通讯作者：
AISEN, AM
中科院分区：
文献类型：
--
作者：
GEBARSKI, SS;GABRIELSEN, TO;AISEN, AM
30 名临床上初步诊断为多发性硬化症的患者接受了与头颅 X 射线计算机断层扫描 (CT) 密切相关的头颅磁共振成像 (MRI)、电诊断研究（视觉诱发反应、脑干听觉诱发反应和体感诱发反应）和脑脊液分析（寡克隆带、髓磷脂碱性蛋白和 IgG/白蛋白比率）。在 30 名患者中，有 26 名患者的 MRI 显示病变符合多发性硬化症，至少部分符合临床预期的神经解剖学病变分布。 4 名 MRI 正常的患者中，有 2 名患者的电诊断研究和脑脊液分析正常，另外 2 名患者有一项异常或模棱两可的电诊断研究。所有 26 名 MRI 异常的患者都至少有一项其他实验室检查异常。 CT仅显示最大的病灶，对于CT异常的患者，MRI显示更多的病灶。在这个有限的系列中，MRI 被证明是多发性硬化症初步诊断的有力工具。它可能被证明是最好的单一测试，其灵敏度超过了电诊断研究和脑脊液分析。
Thirty patients in whom the initial diagnosis of multiple sclerosis was clinically entertained underwent cranial magnetic resonance imaging (MRI) in close temporal relationship to cranial x‐ray computed tomography (CT), electrodiagnostic studies (visual evoked responses, brainstem auditory evoked responses, and somatosensory evoked responses), and cerebrospinal fluid analyses (Oligoclonal bands, myelin basic protein, and IgG/albumin ratio). In 26 of the 30 patients, MRI demonstrated lesions consistent with multiple sclerosis that corresponded, at least in part, with the clinically expected neuroanatomical lesion distribution. Two of the 4 patients with normal MRI had normal electrodiagnostic studies and cerebrospinal fluid analyses, and the other 2 had a single abnormal or equivocal electrodiagnostic study. All 26 patients with abnormal MRI had at least one other abnormal laboratory test. CT revealed only the largest lesions, and in the patients with abnormal CT, MRI demonstrated even more lesions. MRI, in this limited series, proved to be a strong tool in the initial diagnosis of multiple sclerosis; it may prove to be the single best test, with a sensitivity exceeding that of electrodiagnostic studies and cerebrospinal fluid analysis.