臨床神経学

<シンポジウム10―2>臨床と研究に役立つ最新のMRI 学

神経内科領域のMRIをもちいた臨床研究
―1枚の画像をどう評価するか―

伊藤 彰一

千葉大学医学部医学教育研究室〔〒260―8670 千葉市中央区亥鼻1―8―1〕
千葉大学医学部附属病院神経内科

MRI is one of essential tools for neurological diagnosis and useful for assessing contrast differences between lesions and normal tissues and for assessing morphological features of lesions. Here, I introduce published neuroradiological researches conducted in my hospital, especially focusing on features of "signals" and "shapes" of lesions. First, as regards "signals", putaminal T1-hyperintensity is helpful for diagnosing multiple system atrophy, and it is more useful for discriminating multiple system atrophy from Parkinson disease and progressive supranuclear palsy than putaminal T2-hyperintensity rim or putaminal T2-hypointensity. Linear T2-hyperintensity along the medial margin of the globus pallidus is helpful for diagnosis Machado-Joseph disease. Second, as regards "shapes", posterolateral putaminal linearization is a useful finding indicating putaminal atrophy which is a main feature of multiple system atrophy. Flattened facial colliculus fourth ventricular floor is helpful for differentiating Machado-Joseph disease from dentatorublopallidoluysian atrophy and SCA6. A contrast enhancement pattern called "cloudlike enhancement" is specific for neuromyelitis optica comparing with multiple sclerosis. In conclusion, all of these MRI features are easy to recognize and useful for diagnosing patients in daily clinical settings. Careful but simple observation of lesions focusing on "signals" or "shapes" may lead to develop new MRI findings which improve our diagnostic abilities.
Full Text of this Article in Japanese PDF (475K)

(臨床神経, 51:951−954, 2011)
key words:画像診断,MRI,多系統萎縮症,Machado-Joseph病,視神経脊髄炎

(受付日:2011年5月19日)