LEUKOENCEPHALOPATHY IN HTLV-I-ASSOCIATED MYELOPATHY TROPICAL SPASTIC PARAPARESIS - MRI ANALYSIS AND A 2 YEAR FOLLOW-UP-STUDY AFTER CORTICOSTEROID-THERAPY
LEUKOENCEPHALOPATHY IN HTLV-I-ASSOCIATED MYELOPATHY TROPICAL SPASTIC PARAPARESIS - MRI ANALYSIS AND A 2 YEAR FOLLOW-UP-STUDY AFTER CORTICOSTEROID-THERAPY
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DOI：
10.1016/0022-510x(91)90192-a
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发表时间：
1991-11-01
影响因子：
4.4
通讯作者：
HASUO, K
中科院分区：
文献类型：
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作者：
KIRA, J;FUJIHARA, K;HASUO, K
对35例HTLV-I相关性脊髓病（HAM）/热带痉挛性脊髓轻瘫（TSP）患者、19例无HAM/TSP的HTLV-I血清阳性携带者（非HAM/TSP携带者）、18例HTLV-I血清阴性痉挛性脊髓轻瘫（SSP）患者和82例其他神经系统疾病的HTLV-I血清阴性对照者进行了脑磁共振成像（MRI）研究。 HAM/TSP组白色病变发生率（66%）显著高于对照组（23%）和SSP组（11%）。 HAM/TSP携带者多发性白色病变的发生率显著高于非HAM/TSP携带者（37% vs 10%）。 HAM/TSP多灶性影响大脑深部和皮质下白色物质，而不影响脑室周围区域。 Gd-DTPA均未强化。 有白色病变的HAM/TSP患者比无病变的患者病程更长，残疾程度更大。 尽管使用了高剂量皮质类固醇治疗，但随着残疾状况的恶化，白色病变的数量逐渐增加。 所有这些观察结果表明，HAM/TSP脑的MRI异常可能反映了慢性血管周围炎症伴进行性胶质增生（慢性播散性脑脊髓炎）。 我们建议，脑MRI可以成功地利用作为一个可靠的和非侵入性的措施，以下的疾病进展HAM/TSP。
Magnetic resonance imaging (MRI) of the brain was studied in 35 patients with HTLV-I-associated myelopathy (HAM)/tropical spastic paraparesis (TSP), 19 HTLV-I seropositive carriers without HAM/TSP (non-HAM/TSP carriers), 18 patients with HTLV-I seronegative spastic spinal paraparesis (SSP), and 82 HTLV-I seronegative controls with other neurological disorders. The incidence of white matter lesions was significantly higher in HAM/TSP (66%) than in the controls (23%) and SSP (11%). HAM/TSP exceeded non-HAM/TSP carriers significantly in the incidence of multiple white matter lesions (37% vs 10%). HAM/TSP affected the deep and subcortical cerebral white matter multifocally, sparing the periventricular regions. None of the lesions were enhanced by gadolinium-DTPA. HAM/TSP patients with the white matter lesions had both a longer duration of disease and a greater disability than did those without lesions. The white matter lesions gradually increased in number, as the disability status became worse, in spite of the high dose corticosteroid treatment. All these observations suggest that the MRI abnormalities of the HAM/TSP brain may reflect the chronic perivascular inflammation with progressive gliosis (chronic disseminated encephalomyelitis). We propose that brain MRI can be successfully utilized as a reliable and non-invasive measure for following the disease progression in HAM/TSP.