Spinal MRI in patients with suspected multiple sclerosis and negative brain MRI
Spinal MRI in patients with suspected multiple sclerosis and negative brain MRI
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DOI：
10.1093/brain/119.3.709
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发表时间：
1996-06-01
期刊：
影响因子：
14.5
通讯作者：
Miller, DH
中科院分区：
文献类型：
--
作者：
Thorpe, JW;Kidd, D;Miller, DH
尽管MRI对脑内多发性硬化症白质病变的检测灵敏度较高，但少数患者的脑MRI结果正常。我们描述了从 170 多名接受脑部成像检查的患者中选出的 20 名患者，这些患者的异常情况很少（n = 12）或无异常（n = 8）（中位病变数 = 1，范围为 0-3），但脊髓 MRI 却异常。根据 Poser 标准，12 人患有临床明确或实验室支持的明确多发性硬化症；一名患有临床可能的疾病，七名不符合波塞尔标准，被归类为可能的多发性硬化症。所有人都出现了与脊髓或视神经有关的症状和体征。 11 例为原发进展型病程，8 例为复发缓解型，只有 1 例为继发进展型。中度或重度残疾是原发进展病例的规则；所有的复发缓解型患者都有轻微的残疾。所有患者的脊髓中至少有一个可见病变（中位数 2；范围 1-6）。对于脑部 MRI 异常不支持多发性硬化症诊断的患者，脊髓成像可能具有相当大的价值。
Although MRI detects the white matter lesions of multiple sclerosis within the brain with high sensitivity, a minority of patients have normal brain MRI. We describe 20 patients, selected from over 170 who had undergone brain imaging with minimal (n = 12) or no (n = 8) abnormalities (median number of lesions = 1, range, 0-3) but in whom spinal MRI was abnormal. Twelve had clinically definite or laboratory supported definite multiple sclerosis according to the Poser criteria; one had clinically probable disease and seven, not fulfilling the Poser criteria, were classified as possible multiple sclerosis. All had presented with symptoms and signs referable to the spinal cord or optic nerves. Eleven had a primary progressive course, eight relapsing-remitting and only one secondary progressive. Moderate or severe disability was the rule in the primary progressive cases; all the relapsing-remitting patients had minimal disability. All had at least one lesion visible in the spinal cord (median 2; range 1-6). In patients in whom the diagnosis of multiple sclerosis is not supported by abnormalities on brain MRI, imaging of the spinal cord can be of considerable value.