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CentralNervousSystem

南京医科大学一附院放射科洪汛宁hongxunning@4/25/20231放射科中枢英文版CentralNervousSystem第1页CategoriesofWhiteMatterDiseaseDemyelinatingNormalmyelinisinjuredordestroyedFurtherdividedintoprimaryandsecondaryDysmyelinatingIntrinsicabnormalityofmyelinformationormaintenanceRare,usuallyseeninpediatricpopulation4/25/20232放射科中枢英文版CentralNervousSystem第2页DemyelinatingDisordersPrimarydemyelinatingdiseaseMultiplesclerosisSecondarydemyelingatingdiseaseAcutedisseminatedencephalomyelitisProgressivemultifocalleukoencephalopathyOsmoticdemyelinationDisseminatedNecrotizingLeukoencephalopathyChemotherapyandradiation4/25/20233放射科中枢英文版CentralNervousSystem第3页MultipleSclerosis:EpidemiologyMostcommondemyelinatingdiseaseencounteredinpractice Firstdescribedin1868byCharcotFemalepredominanceSecondtofifthdecadesoflifeNorthernEuropeanextractionTemperateclimates4/25/20234放射科中枢英文版CentralNervousSystem第4页MultipleSclerosis:ClinicalPresentationEvidenceoftwoormorewhitematterlesionsseparatedbytimeandindifferentlocationsRangeofsymptomsCranialnervepalsyOpticneuritisVaguesensorycomplaintsParesisVariablepatternofpresentationExacerbationsandremissionsChronicprogressiveAttackfollowedbyabsenceofclinicaldiseaseRapidlyprogressive4/25/20235放射科中枢英文版CentralNervousSystem第5页MultipleSclerosis:DiagnosisSchumacher’scriteria:twoormorewhitematterlesionswitheither…Twoormoreepisodesofworsening,eachlastingatleast24hrsandeachatleastamonthapartSlowstepwiseprogressionofsignsorsymptomsforatleastsixmonthsMRplaysroleinconfirmingclinicaldiagnosisPossitivestudywithappropriateclinicaldatastronglysupportsdiagnosisofMS4/25/20236放射科中枢英文版CentralNervousSystem第6页MultipleSclerosis:PathologyMyelinbreakdownwithassociatedlymphocyteandmacrophageinfiltrationofaffectedareaAstrocyteproliferationandinfiltrationofdemyelinatedarea,withcontinuedsignsofinflammationGlioticregionswithdecreasedcellularityandnomyelin4/25/20237放射科中枢英文版CentralNervousSystem第7页MultipleSclerosis:Dawson’sFingerInflammatorylesionsalongperiventricularmedullaryveinsRadiatefromventricularsurfaceLesionspreceeddemyelination4/25/20238放射科中枢英文版CentralNervousSystem第8页MultipleSclerosis:ImagingAdjuncttoclinicalsignsandsymptomsConfirmorfailtoconfirmclinicalsuspicionofMSSuggestplausiblealternativediagnosisSensitivityofMRsurpassesthatofallnon-invasivetests.TypicalappearanceonMRT1:isointensetolowintensityT2:highintensityFLAIR:highintensity4/25/20239放射科中枢英文版CentralNervousSystem第9页MultipleSclerosis:ImagingLocationiscriticalPeriventricularwhitematter4/25/202310放射科中枢英文版CentralNervousSystem第10页MultipleSclerosis:ImagingLocationiscriticalPeriventricularwhitematterCorpuscallosum4/25/202311放射科中枢英文版CentralNervousSystem第11页MultipleSclerosis:ImagingLocationiscriticalPeriventricularwhitematterCorpuscallosumVisualpathway4/25/202312放射科中枢英文版CentralNervousSystem第12页MultipleSclerosis:ImagingLocationiscriticalPeriventricularwhitematterCorpuscallosumVisualpathwayMiddlecerebralpeduncle4/25/202313放射科中枢英文版CentralNervousSystem第13页MultipleSclerosis:ImagingLocationiscriticalPeriventricularwhitematterCorpuscallosumVisualpathwayMiddlecerebralpeduncleCervicalspine4/25/202314放射科中枢英文版CentralNervousSystem第14页MultipleSclerosis:ImagingContrastenhancementtoassesforchronicity(+)enhancementrepresentsactivediseasePolyphasicityoflesionssupportMS4/25/202315放射科中枢英文版CentralNervousSystem第15页MultipleSclerosis:ImagingContrastenhancementtoassesforchronicity(+)enhancementrepresentsactivediseasePolyphasicityoflesionssupportMS4/25/202316放射科中枢英文版CentralNervousSystem第16页MultipleSclerosis:ImagingVariableappearanceSmallandpunctateLarge&confluent4/25/202317放射科中枢英文版CentralNervousSystem第17页TumefactiveMSAssociatedwithothernoncontiguousbrainandspinalcordlesionsLeadingedgeofenhancementandincompletering(horseshoe)Perfusion–glioma(increasedCBV),MS(usuallynot)VeinscoursethroughlesioninMSbutdisplacedbytumor4/25/202318放射科中枢英文版CentralNervousSystem第18页MultipleSclerosis:Imaging4/25/202319放射科中枢英文版CentralNervousSystem第19页4/25/202320放射科中枢英文版CentralNervousSystem第20页4/25/202321放射科中枢英文版CentralNer

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