成人急性播散性脑脊髓炎脑部的MRI 表现及临床分析

目的:探讨成人急性播散性脑脊髓炎(ADEM)的脑部MRI表现特点。方法:回顾性分析符合临床诊断标准的成人ADEM患者8例。8例均进行MRI平扫,7例进行增强扫描。采用自旋回波(SE)序列、快速自旋回波(FSE)序列、FLAIR序列及EPI序列扫描。常规行矢状面、横断面及冠状面扫描。结果:(1)病变主要位于双侧侧脑室周围及额、顶、颞、枕皮质下白质区,主要特点为多发且分布大部分不对称,双侧侧脑室旁白质可见"垂直脱髓鞘征",病灶部分呈对称分布,同时累及丘脑、脑干、胼胝体、小脑白质或大脑皮质。4例累及双侧丘脑,病灶呈对称性分布。(2)8例病变信号均以长及略长TW1信号、长TW2信号为主,3例在病变中心可见更长TW1、更长TW2信号。(3)7例平扫异常信号增强扫描均可见不同程度异常强化,急性期病灶多呈点、斑片状、环形、类圆形及索条状强化。结论:ADEM脑部的MRI表现具有一定特征性,MRI具有重要诊断价值。

MRI Imaging and Clinical Study of the Brain in Adult with Acute Disseminated Encephalomyelitis

Objective: To discuss cerebral MRI features of the brain with acute disseminated encephalomyelitis(ADEM).in audlt.Methods: Reviewed 8 cases in audlt of acute disseminated encephalomyelitis developd clinical symptoms.8 cases were plain and 7 cases were enhanced.Using SE,FSE,FLAIR and EPI sequences.axial,sagittal,and coronal scanning were accomplished.Results:(1) Mulitiple and asymentrica white matter lesions were revealed in the frontal,parietal,occipital,temporal,and perventricular areas.The lesions mainly blocated in cerebral white matter,symmetrical"Perpendicula sign" by lateral was seen,Part of the lesions involing the thalamus,the brain stem,corpus callosum,the callosum,the cerebellum white matter or brain cortex,4 cases were symmetry distribution in thebilateral thala-mus.(2) The lesions were presented as low or lower signal on T1WI and high signal on T2WI,3 cases had the lowst signal on TIWI and higher signal on T2WI in the center.(3) Differend degree abnormal signal was seen in 7 cases,presenting as spotted,flake,ring-shaped,kind of circular,strip lesions in the acute phase.Conclusions: ADEM carries certain characteristics on MRI in the brain,MRI has greatly value in its diag-nosis.