放射科中枢英文版CentralNervousSystem培训课件.ppt

1、文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Categories of White Matter Disease Demyelinating Normal myelin is injured or destroyed Further divided into primary and secondary Dysmyelinating Intrinsic abnormality of myelin formation or maintenance Rare,usually seen in pediatric population2022-10-91文档仅供参考，不

2、能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Demyelinating Disorders Primary demyelinating disease Multiple sclerosis Secondary demyelingating disease Acute disseminated encephalomyelitis Progressive multifocal leukoencephalopathy Osmotic demyelination Disseminated Necrotizing Leukoencephalopathy Chemotherapy and

3、 radiation2022-10-92文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Multiple Sclerosis:Epidemiology Most common demyelinating disease encountered in practice First described in 1868 by Charcot Female predominance Second to fifth decades of life Northern European extraction Temperate climates2022-10-93文档仅供参考，

4、不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Multiple Sclerosis:Clinical Presentation Evidence of two or more white matter lesions separated by time and in different locations Range of symptoms Cranial nerve palsy Optic neuritis Vague sensory complaints Paresis Variable pattern of presentation Exacerbations and

5、remissions Chronic progressive Attack followed by absence of clinical disease Rapidly progressive2022-10-94文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Multiple Sclerosis:Diagnosis Schumachers criteria:two or more white matter lesions with either Two or more episodes of worsening,each lasting at least 24

6、hrs and each at least a month apart Slow stepwise progression of signs or symptoms for at least six months MR plays role in confirming clinical diagnosis Possitive study with appropriate clinical data strongly supports diagnosis of MS2022-10-95文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Multiple Sclerosi

7、s:Pathology Myelin breakdown with associated lymphocyte and macrophage infiltration of affected area Astrocyte proliferation and infiltration of demyelinated area,with continued signs of inflammation Gliotic regions with decreased cellularity and no myelin2022-10-96文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或

8、本人删除。Multiple Sclerosis:Dawsons Finger Inflammatory lesions along periventricular medullary veins Radiate from ventricular surface Lesions preceed demyelination2022-10-97文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Multiple Sclerosis:Imaging Adjunct to clinical signs and symptoms Confirm or fail to confir

9、m clinical suspicion of MS Suggest plausible alternative diagnosis Sensitivity of MR surpasses that of all non-invasive tests.Typical appearance on MR T1:isointense to low intensity T2:high intensity FLAIR:high intensity2022-10-98文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Multiple Sclerosis:ImagingLocat

10、ion is critical Periventricular white matter2022-10-99文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Multiple Sclerosis:ImagingLocation is critical Periventricular white matter Corpus callosum2022-10-910文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Multiple Sclerosis:ImagingLocation is critical Periventricular whi

11、te matter Corpus callosum Visual pathway2022-10-911文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Multiple Sclerosis:ImagingLocation is critical Periventricular white matter Corpus callosum Visual pathway Middle cerebral peduncle2022-10-912文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Multiple Sclerosis:ImagingLoc

12、ation is critical Periventricular white matter Corpus callosum Visual pathway Middle cerebral peduncle Cervical spine2022-10-913文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Multiple Sclerosis:Imaging Contrast enhancement to asses for chronicity(+)enhancement represents active disease Polyphasicity of lesi

13、ons support MS2022-10-914文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Multiple Sclerosis:Imaging Contrast enhancement to asses for chronicity(+)enhancement represents active disease Polyphasicity of lesions support MS2022-10-915文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Multiple Sclerosis:Imaging Variable app

14、earance Small and punctate Large&confluent2022-10-916文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Tumefactive MS Associated with other noncontiguous brain and spinal cord lesions Leading edge of enhancement and incomplete ring(horseshoe)Perfusion glioma(increased CBV),MS(usually not)Veins course through l

15、esion in MS but displaced by tumor2022-10-917文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Multiple Sclerosis:Imaging2022-10-918文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。2022-10-919文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。2022-10-920文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Multiple Sclerosis:Differential Diagnosis Lyme disease Ischemic white matter lesions Virchow-robin spaces Migraine2022-10-921文档仅供参考，不能作为科学依据，请勿模仿；如有不当之处，请联系网站或本人删除。Thank you！2022-10-922