多發性硬化之磁振造影

Magnetic resonance imaging (MRI), the latest test for evaluation of multiple sclerosis (MS), was assessed in 15 cases with clnically definite MS (CDMS) at NUTH from October 1990 to March 1992. MRI was positive in 14 of 15 patients (93%). The frequencies of sites of plaques in MRI were: 77% in the cerebrum, 77% in the posterior fossa, 82% in the spinal cord, and 0% in the optic nerve. It was interesting to find long segment of spinal involvement (＞6 cm) in 4 of 9 positive spinal MRI. Comparing clinical symptoms/signs (S/S) and MRI findings, we found that: (1) in the cerebrum, MRI was much more sensitive than clinical S/S; (2) in the spinal cord, clinical S/S had very good concurrent rate with MRI; and (3) in optic nerve, the clinical S/S was much more accurate than routine brain MRI. Enhancement of Gd-DTPA was found in only 6 (55%) of 11 patients with acute exacerbating MS. In Taiwan, optic and spinal cord S/S were most frequently seen in the course of MS. We suggest head MRI as the first choice test for those suspected MS patients, since (1) poor orbit MRI sensitivity and good spinal cord clinical-MR concurrent rate render MRI of orbit and spinal cord less helpful in diagnosing MS. In addition, head MRI has high positive rate (about 90%) in CDMS if patient has optic or spinal cord S/S For economic reason, head MRI should be the first choice for these patients.