RSNA精选鉴别视神经
2021-8-28 来源：不详 浏览次数：次白癜风怎样治疗好 http://m.39.net/pf/a_6706972.html
TheImportanceofBeingEarnestinDifferentiatingNMOSDfromMS
AtkinsonMorleyWing,St.GeorgesHospital,London,UK
DrAdamYoussef,DrAudreySinclair,DrDeclanJohnson
鉴别视神经脊髓炎谱系疾病(NMOSD)和多发性硬化(MS)的重要意义
?DistinguishingNMOSD(NeuromyelitisOpticaSpectrumDisorder)fromMSandCNSinflammatorymimicshasimportanttherapeutic治疗andprognostic预后implicationsandisrevolutionisingmanagement
?MRIcharacterisationandbiomarker生物标记物discoverieshaveincreasedourunderstandingofCNSinflammatorydisorders
Teachingpoints:
IdentifytypicalMRIpatternsofNMOSDasopposedtoMS
NeuroimagingfindingsinNMOSDasopposedtoMS
ClinicalandNeuroimagingdifferencesinMSanddifferentsubtypesofNMOSD
Caseexamples
Differential/Mimics
Treatmentandprognosis
Terminology:
★Disseminationinspace空间上传播:ThedevelopmentoflesionsindistinctanatomicallocationswithintheCNS-i.e.indicatingamultifocalCNSprocess.
★Disseminationintime时间上传播:ThedevelopmentorappearanceofnewCNSlesionsovertime.
★Infratentorial幕下的MRIlesion:AT2-hyperintenselesioninthebrainstem(typicallynearthesurface),cerebellarpeduncles小脑脚,orcerebellum.
★Juxtacortical近皮质的MRIlesion:AT2-hyperintensecerebralwhitematterlesionabuttingthecortex皮质andnotseparatedbywhitematter.
★DeepGreymatterMRIlesion:AT2-hyperintenselesionofthedeepgreymatterstructuresseenonT2.
★CorticalMRIlesions:Lesionswithinthecerebralcortex大脑皮质.Typically,specialMRltechniquesarerequiredtovisualisetheselesions.Careisneededtodistinguishpotentialcorticallesionsfromneuroimagingartefacts神经影像伪影.
★Periventricular脑室周围MRIlesion:AT2-hyperintensecerebralwhitematterlesionabuttingthelateralventricles侧脑室withoutwhitematterinbetween,includinglesionsinthecorpuscallosum胼胝体butexcludinglesionsindeepgreymatterstructures.
★Spinalcord脊髓MRIlesion:Ahyperintenselesioninthecervical颈的,thoracic胸的,orlumbar腰的spinalcordseenonT2/STIR,orintwoplanesonT2images.
ImagingfindingsmoreinkeepingwithMS
Brain
?Lesionswithorientationperpendiculartoalateralventricle(Dawsonfingers(In,Dr.JamesWalkerDawsonnoticedapatternofplaquesinthebrainsofpeoplewithMS.Now,theseso-calledlesionsthatdoctorscallDawson’sfingersareatypicalsignofMS.))
?Lesionsadjacenttothetemporalhorns(lateralventricle)
?JuxtacorticallesionsinvolvingsubcorticalU-fibers
?Corticallesions
?Involvementofinferiorcorpuscallosum(callososeptalinterface)
Spinalcord
?Shortlesions3
