MRI diagnosis of multiple cerebral sclerosis / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the magnetic resonance imaging (MRI) feature of multiple cerebral sclerosis (MS) for better understanding and diagnosis of this disease.</p><p><b>METHODS</b>The MRI data of 32 patients with MS were reviewed. Conventional scanning with T1WI, T2WI, Flair sequence was performed, and 26 patients underwent Gd-DTPA enhanced scanning. The MS plaques were analyzed for their locations, sizes, shapes, MR signals and enhanced features, space-occupying signs, and the related corpus callosum changes and brain atrophy. Descriptive statistical method was used for all the data.</p><p><b>RESULTS</b>MRI identified MS lesions in the brain in 30 cases, with the sensitivity of 93.75%. All the MS patients had multiple lesions with predilection sites of the cortical/juxtacortical and periventricle areas, the centrum semiovale, and the corpus callosum. Most of the MS plaques were round or oval of different sizes. Bilateral lesions were almost symmetrical in distribution. Twenty patients had "rectangular demyelination" and 12 had "dirty white matter" signs, and 11 had both manifestations. The lesions were isointense, slightly hypointense or hypointense on T1WI, and hyperintense on T2WI and Flair sequences. Most of the MS plaques presented no enhancement, with occasional nodular or circular enhancement. No or slight space-occupying effect was found in the plaques. Of the 28 MS patients undergoing sagittal scanning of the corpus callosum, 17 presented with abnormal signals, with the sensitivity of 60.71% (17/28). Five patients had corpus callosum atrophy, and 10 had brain atrophy of different degrees.</p><p><b>CONCLUSION</b>These results suggest that the corpus callosum is often compromised by the MS lesions to present diffusive, nodular, radiating signal abnormalities and irregular ependymal thickening, which can be most obvious with sagittal FLAIR imaging.</p>

Clinical and MRI diagnosis of brain multiple sclerosis / 中华神经医学杂志

Objective To study the clinical and MRI features of multiple sclerosis and to get a better understanding and diagnosing level of brain multiple sclerosis. Methods Twenty patients of brain multiple sclerosis were evaluated retrospectively with regard to clinical data, lesion location,shapes, MR signal and enhancement patterns, as well as the changes of corpus callosum. Results Multiple sclerosis often occurred in young and middle-aged women with acute and subacute onset. The initial symptoms included visual disturbance, acrognosis or motor disturbance. The vision-evoked potential was abnormal in most patients. Lesions were found in 18 patients by MRI scanning, the sensitivity of MKI being 90% (18/20). The distribution of lesions were observed most frequently at the two sides of periventricle, cortical and juxtacortical of frontal lobe and centrum semiovale. The shape of lesions were mostly round or ovate with different sizes. Two typical manifestations of multiple sclerosis were "right-angle demyelination sign" and "dirty-appearing white matter ". The lesions showed as isointensive or hypointensive on T1WI, hyperintensive on T2WI and Flair sequences. The lesions showed as nodular enhancement, ringlike enhancement, arc enhancement or nonenhancment on T1 enhancement scanning. Conclusions MRI appearances of multiple sclerosis have some characteristics. MRI is helpful to diagnosis and differential diagnosis of multiple sclerosis, and also the most sensitive imaging method for multiple sclerosis.