中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病的MR診斷中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病1邳州第一附屬醫(yī)院州大學(xué)第一臨學(xué)院|原詞南區(qū)科大學(xué)第一附尾漢院MIEDCOIN原發(fā)CNS炎性脫髓鞘疾病的MRI診斷MRIdiagnosisofinflammatorydemyelinationdiseaseinCNS鄭州大學(xué)第一附屬醫(yī)院張勇邳州第一附屬醫(yī)院2》脫髓鞘疾病:一組以神經(jīng)髓鞘脫失為主要病理表現(xiàn)的疾病嗜蘇丹性白質(zhì)營(yíng)養(yǎng)不良多發(fā)性硬化MEDCON腎上腺腦白質(zhì)灣養(yǎng)不良按發(fā)病時(shí)髓鞘視神經(jīng)脊髓炎先天性皮質(zhì)外軸索發(fā)育不全發(fā)育正常與否急性播散性腦脊髓炎Cockayne綜合征急性出血性白質(zhì)腦炎新生兒嗜蘇丹染色性白質(zhì)營(yíng)養(yǎng)不良彌漫性硬化同心圓性硬化腦橋中部髓鞘溶解癥腦脂質(zhì)沉積病球樣細(xì)胞腦臼質(zhì)營(yíng)養(yǎng)不良進(jìn)征性多灶性白質(zhì)腦病異染性白質(zhì)營(yíng)養(yǎng)不良巨腦性嬰兒白質(zhì)營(yíng)養(yǎng)不良海綿狀腦病髓鞘發(fā)育異常的瞄鞘發(fā)育正常的脫髓鞘疾病脫髓鞘疾病邳州第一附屬醫(yī)院》脫髓鞘疾病:一組以神經(jīng)髓鞘脫失為主要病理表現(xiàn)的疾病3CNs炎性脫髓鞘疾病概述●CNs炎性脫髓鞘疾病,是一組具有免疫易感人群發(fā)生的,與免疫介導(dǎo)相關(guān)的,原發(fā)或特發(fā)于腦(包括視神經(jīng))和/或脊髓受累的炎性脫髓鞘病變●病因及發(fā)病機(jī)制復(fù)雜、臨床和影像學(xué)表現(xiàn)多樣、對(duì)治疔的反應(yīng)性個(gè)體差異較大按髓鞘本身病變或其他病因累及髓鞘病變,分為原發(fā)性和繼發(fā)性兩類原發(fā)性CNS炎性脫髓鞘的常見疾病,包括多發(fā)性硬化、視神經(jīng)脊髓炎、急性播散性腦脊髓炎等繼發(fā)性CNS炎性脫髓鞘疾病,包括一氧化碳中毒、維生素B12缺乏、汞中毒、酒精中毒、缺氧、放射性損傷等州琴第一附屬醫(yī)院CNs炎性脫髓鞘疾病概述4多發(fā)性硬化(multiplesclerosis,Ms)●最常見的中樞神經(jīng)系統(tǒng)的脫髓鞘疾病,好發(fā)于中青年女性●白種人和高緯度居民的發(fā)病率較高病因不明:可能與遺傳、病毒感染、環(huán)境等因素有關(guān)發(fā)病部位:可累及大腦、小腦、腦干、脊髓和視神經(jīng)灰白質(zhì)結(jié)構(gòu)均可受累臨床表現(xiàn):復(fù)雜多變,緩解與復(fù)發(fā)常交替發(fā)生。常有感覺或運(yùn)動(dòng)障礙,也可岀現(xiàn)精神癥狀和認(rèn)知功能障礙實(shí)驗(yàn)室:腦脊液寡克隆帶多為陽性NormalNerveCelNerveCellwithtiplesclerosis建州軍第一附屬醫(yī)院多發(fā)性硬化(multiplesclerosis,Ms)5中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件6中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件7中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件8中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件9中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件10中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件11中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件12中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件13中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件14中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件15中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件16中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件17中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件18中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件19中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件20中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件21中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件22中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件23中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件24中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件25中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件26中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件27中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件28中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件29中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件30中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件31中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件32中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件33中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件34中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件35中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件36中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件37中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件38中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件39中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件40中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件41中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件42中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件43中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件44中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件45中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件46中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件47中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件48中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病的MR診斷中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病49邳州第一附屬醫(yī)院州大學(xué)第一臨學(xué)院|原詞南區(qū)科大學(xué)第一附尾漢院MIEDCOIN原發(fā)CNS炎性脫髓鞘疾病的MRI診斷MRIdiagnosisofinflammatorydemyelinationdiseaseinCNS鄭州大學(xué)第一附屬醫(yī)院張勇邳州第一附屬醫(yī)院50》脫髓鞘疾病:一組以神經(jīng)髓鞘脫失為主要病理表現(xiàn)的疾病嗜蘇丹性白質(zhì)營(yíng)養(yǎng)不良多發(fā)性硬化MEDCON腎上腺腦白質(zhì)灣養(yǎng)不良按發(fā)病時(shí)髓鞘視神經(jīng)脊髓炎先天性皮質(zhì)外軸索發(fā)育不全發(fā)育正常與否急性播散性腦脊髓炎Cockayne綜合征急性出血性白質(zhì)腦炎新生兒嗜蘇丹染色性白質(zhì)營(yíng)養(yǎng)不良彌漫性硬化同心圓性硬化腦橋中部髓鞘溶解癥腦脂質(zhì)沉積病球樣細(xì)胞腦臼質(zhì)營(yíng)養(yǎng)不良進(jìn)征性多灶性白質(zhì)腦病異染性白質(zhì)營(yíng)養(yǎng)不良巨腦性嬰兒白質(zhì)營(yíng)養(yǎng)不良海綿狀腦病髓鞘發(fā)育異常的瞄鞘發(fā)育正常的脫髓鞘疾病脫髓鞘疾病邳州第一附屬醫(yī)院》脫髓鞘疾病:一組以神經(jīng)髓鞘脫失為主要病理表現(xiàn)的疾病51CNs炎性脫髓鞘疾病概述●CNs炎性脫髓鞘疾病,是一組具有免疫易感人群發(fā)生的,與免疫介導(dǎo)相關(guān)的,原發(fā)或特發(fā)于腦(包括視神經(jīng))和/或脊髓受累的炎性脫髓鞘病變●病因及發(fā)病機(jī)制復(fù)雜、臨床和影像學(xué)表現(xiàn)多樣、對(duì)治疔的反應(yīng)性個(gè)體差異較大按髓鞘本身病變或其他病因累及髓鞘病變,分為原發(fā)性和繼發(fā)性兩類原發(fā)性CNS炎性脫髓鞘的常見疾病,包括多發(fā)性硬化、視神經(jīng)脊髓炎、急性播散性腦脊髓炎等繼發(fā)性CNS炎性脫髓鞘疾病,包括一氧化碳中毒、維生素B12缺乏、汞中毒、酒精中毒、缺氧、放射性損傷等州琴第一附屬醫(yī)院CNs炎性脫髓鞘疾病概述52多發(fā)性硬化(multiplesclerosis,Ms)●最常見的中樞神經(jīng)系統(tǒng)的脫髓鞘疾病,好發(fā)于中青年女性●白種人和高緯度居民的發(fā)病率較高病因不明:可能與遺傳、病毒感染、環(huán)境等因素有關(guān)發(fā)病部位:可累及大腦、小腦、腦干、脊髓和視神經(jīng)灰白質(zhì)結(jié)構(gòu)均可受累臨床表現(xiàn):復(fù)雜多變,緩解與復(fù)發(fā)常交替發(fā)生。常有感覺或運(yùn)動(dòng)障礙,也可岀現(xiàn)精神癥狀和認(rèn)知功能障礙實(shí)驗(yàn)室:腦脊液寡克隆帶多為陽性NormalNerveCelNerveCellwithtiplesclerosis建州軍第一附屬醫(yī)院多發(fā)性硬化(multiplesclerosis,Ms)53中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件54中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件55中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件56中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件57中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件58中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件59中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件60中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件61中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件62中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件63中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件64中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件65中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件66中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件67中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件68中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件69中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件70中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件71中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件72中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件73中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件74中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件75中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件76中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件77中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件78中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件79中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件80中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件81中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件82中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件83中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件84中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件85中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件86中樞神經(jīng)系統(tǒng)炎性脫髓鞘疾病MRI診斷課件87中樞神經(jīng)系統(tǒng)炎性脫髓鞘