刘瑞华;周海涛;张鹏远;李艳;

• 1:郑州大学附属洛阳中心医院

摘要(Abstract)：

目的分析视神经脊髓炎谱系疾病(NMOSD)患者的首发症状和影像学特点。方法选取2014-01—2019-09在郑州大学附属洛阳中心医院神经内科住院并诊断为NMOSD的患者为研究对象,并进行回顾性研究,了解其首发症状、病例特点和影像学表现等。结果 40例患者中以视神经炎为首发表现者占42.5%,以脊髓炎为首发表现者占42.5%,以最后区综合征为首发表现者占10.0%,以脑干综合征和大脑综合征为首发表现者各占2.5%;复发率82.5%(33/40),其中颅内病灶为首发的患者均有复发;首次发作误诊率为55%(22/40);头颅MRI中延髓受累最多(61.5%),其次是皮层和皮层下(23.1%);脊髓MRI中颈胸髓同时受累最多(51.6%),其次是仅颈髓受累(32.3%)和仅胸髓受累(12.9%),视神经MRI中可表现为视神经水肿增粗(46.7%)和萎缩变细(33.3%)。结论 NMOSD首发症状临床表现各异,首发误诊、漏诊率高,复发率高,MRI有特征性表现,对不明原因的急性视神经炎、长节段脊髓炎,以及急性起病的大脑、脑干、间脑、最后区综合征患者,需尽早明确有无NMOSD可能。

关键词(KeyWords)： 视神经脊髓炎谱系疾病;首发症状;影像学特点;误诊;复发

Abstract:

Keywords:

基金项目(Foundation): 洛阳市医疗卫生科技计划项目（编号：1910024A）;; 河南省医学科技攻关计划（编号：2018020903）

作者(Authors): 刘瑞华;周海涛;张鹏远;李艳;

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