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多发性硬化(multiple sclerosis,MS)是最常见的中枢神经系统白质脱髓鞘疾病,以病灶多发、病程缓解与复发交替为特征。CT显示MS斑的阳性率仅为MRI的54.6%,在小脑、脑干及胼胝体上更低。MRI对MS诊断的敏感性比CT高,很多CT阴性者常能在MRI上显示病灶,特别是对后颅窝和脊髓病灶,MRI更优于CT。常规MRI技术检查局部白质病灶有极高的灵敏度,新的定量MRI技术对正常脑白质轻微改变的灵敏度增高以及对MS不均一性的病理学变化特异性增加。磁化传递成像、弥散加权成像、弥散张量成像(MTI、DWI、DTI)细胞特异性成像能够提供关于T2可见病灶内外细胞和结构改变的信息。常规和新的MRI技术的广泛应用将会提高对MS的诊断。
Multiple sclerosis (MS) is the most common demyelinating disease of the white matter of the central nervous system. It is characterized by frequent lesions, alternation of course of disease and relapse. CT showed that the positive rate of MS plaques was only 54.6% in MRI and lower in cerebellum, brain stem and corpus callosum. MRI is more sensitive to MS than CT, and many CT negatives often show lesions on MRI, especially in the posterior fossa and spinal cord lesions. MRI is superior to CT. Conventional MRI has the highest sensitivity for detecting localized white matter lesions. The new quantitative MRI technique has increased sensitivity to mild changes in normal white matter and pathological changes to MS heterogeneity. Magnetic resonance imaging, diffusion-weighted imaging, and diffusion-tensor imaging (MTI, DWI, DTI) cell-specific imaging can provide information about changes in cells and structures inside and outside T2 visible lesions. The widespread use of routine and new MRI techniques will improve the diagnosis of MS.