【摘要】 目的探讨特发性急性横贯性脊髓炎(IATM)的临床特征及MRI特点,提高对其诊断准确性。方法对41例首次发病并住院诊治的IATM患者的临床资料及MRI图像进行回顾性分析。结果 (1)临床症状:首发症状为肢体麻木无力共28例(68.29%);截瘫12例(29.27%),尿便障碍/失禁25例(60.98%)。查体所有患者均有感觉障碍并伴有明确的感觉平面,其中39例(95.12%)表现为痛觉减退,2例(4.88%)表现为痛觉过敏。(2)MRI特征:41例患者中38例(92.68%)MRI显示异常,表现为T2WI条片状高信号,其中颈髓11例(28.95%),胸髓22例(57.89%),颈胸髓1例(2.63%),胸髓及马尾4例(10.53%);脊髓肿胀11例(28.95%)。21例患者行增强扫描检查,13例(61.90%)轻-中度强化。结论肢体麻木无力、尿便障碍及确切感觉平面以下的痛觉减退为IATM较主要的临床表现。临床表现与MRI特征相结合,有利于IATM的诊断。更多还原

【Abstract】 Objective To investigate the clinical features and MRI characteristics of idiopathic acute transverse myelitis(IATM)in order to improve its diagnostic accuracy.Methods Retrospective analysis was performed on the clinical data and MRI images of 41 IATM patients who were diagnosed and treated at initial presentation in our hospital.Results(1)Clinical symptoms-28 cases(68.29%)showed numbness and weakness of limbs,12 cases(29.27%)showed paraplegia,25 cases(60.98%)showed urination and defecation disorders.All the patients had sensory disturbance under clear sensory plane.39 cases(95.12%)were hypalgesia,2 cases(4.88%)were hyperalgesia.(2)MRI characteristics-38(92.68%)patients showed high signal intensity on T2WI images,including 11 with lesions(28.95%)located in the cervical spinal cord,22 with lesions(57.89%)in thoracic spinal cord,1 with lesion(2.63%)in cervical and thoracic spinal cord,and 4 with lesions(10.53%)in thoracic spinal cord and cauda equine;spinal cord swelling was found in 11 cases(28.95%).Contrast-enhanced scan was performed to 21 patients,13 of whom(61.90%)had enhancement.Conclusion Numbness and weakness of limbs and hypalgesia under clear sensory levels are the main clinical manifestations of IATM.The combination of clinical features and MRI characteristics is helpful for the diagnosis of IATM.更多还原