多发性硬化的MRI诊断_培训课件.pptVIP

Multiple Sclerosis white matter micrometer Multiple Sclerosis Central nervous Central nervous system Central nervous Multiple Sclerosis Multiple Sclerosis white matter Multiple Sclerosis Multiple Sclerosis Multiple Sclerosis Multiple Sclerosis Typical skin rash皮疹 caused by spirochaet transmitted by a tick蜱. Clinically Lyme presents with acute CNS symptoms and sometimes transverse myelitis横贯性脊髓炎 . MS-like lesions in Lyme‘s disease.莱姆病表现相似MS Sarcoid结节病Sarcoid is the great mimicker相仿. The distribution of lesions is quite similar to MS. The distribution of lesions is quite similar to MS.Besides lesions in the deep WM, there are some juxtaiventricular lesions and even Dawson finger-like lesions.The final diagnosis was sarcoid. Sarcoid has surpassed neurosyphilis神经梅毒 as the great mimicker. There is punctate点状 enhancement in the basal nuclei基底节. This is seen in sarcoid and can also be seen in SLE or other vasculitis血管炎. Typical for sarcoid in this case is the leptomeningeal软脑膜 enhancement (yellow arrow). This is the result of granulomatous inflammation肉芽肿性炎 of the leptomeninges.  Another typical finding in this same case is the linear enhancement (yellow arrow). This is due to inflammation along the Virchow Robin spaces. This is also a form of leptomeningeal enhancement. Virchow Robin spacesKey finding: Bright on T2WI and dark on FLAIR. T2WI and FLAIR On the T2 image there are multiple high intensity lesions in the basal ganglia基底节.On the FLAIR image these lesions are dark, so they follow the intensity of CSF on all sequences (they were hypointense in the T1WI).This signal intensity in combination with the location is typical for VR spaces. HIV Key finding: Atrophy萎缩and symmetric对称性periventricular室周or more diffuse WMLs in AIDS patient. vessel dieaseWMLs白质病变 in the deep white matter. Not located in corpus callosum胼胝体, juxtaventricular近脑室 or juxtacortical近皮层. Unlike in MS, they do not touch the