Cerebrospinal fluid pleocytosis in multiple sclerosis patients with lesions showing reduced diffusion
Cerebrospinal fluid pleocytosis in multiple sclerosis patients with lesions showing reduced diffusion
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DOI：
10.1177/1352458513515083
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发表时间：
2014-09-01
影响因子：
5.8
通讯作者：
Gass, Achim
中科院分区：
文献类型：
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作者：
Eisele, Philipp;Szabo, Kristina;Gass, Achim
在多发性硬化症 (MS) 中，偶尔急性病变会在磁共振成像 (MRI) 上显示表观扩散系数 (ADC) 降低；然而，这种现象的根本机制尚不清楚。我们将 25 名 MS 或后来确诊为 MS 的临床孤立综合征 (CIS) 患者的脑脊液 (CSF) 结果与急性病变的弥散 MRI 信号特征进行了比较。在症状出现后第 1 天至第 4 天接受调查的 25 名患者中，有 9 名患者的病灶内 ADC 值降低（-15% 至 -51%），并伴有明显的脑脊液细胞增多（11-46 个白细胞/μl）。我们的结果表明，急性多发性硬化症病变中 ADC 减少的现象可能与脑脊液细胞增多间接表明的侵袭性炎症环境有关。此外，仅在症状出现后早期观察到 ADC 降低和脑脊液细胞增多，这表明两者通常都是早期和短暂的现象。
In multiple sclerosis (MS) occasionally acute lesions show a reduced apparent diffusion coefficient (ADC) on magnetic resonance imaging (MRI); however, the underlying mechanism of this phenomenon is not known. We compared cerebrospinal fluid (CSF) findings with diffusion MRI signal characteristics of acute lesions in 25 patients with MS or a clinically isolated syndrome (CIS) later confirmed as MS. In nine of 25 patients investigated between days 1 and 4 after symptom onset, a reduced intralesional ADC value (-15% to -51%) was accompanied by a marked CSF pleocytosis (11-46 leukocytes/mu l). Our results suggest that ADC reduction in acute MS lesions is a phenomenon that is possibly related to an aggressive inflammatory milieu as indirectly indicated by CSF pleocytosis. Furthermore, the ADC reduction and CSF pleocytosis were observed only early after symptom onset, which suggests that both are typically early and transient phenomena.