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目的：探讨多发性硬化（ＭＳ）与脑梗塞的核磁共振成像（ＭＲＩ）病灶特征及鉴别方法。方法：分析临床确诊的ＭＳ２２８例及脑梗塞１６２例的脑部ＭＲＩ病灶的大小、数量、分布和形态。结果：在ＭＳ长轴５～１５ｍｍ的病灶为多，在脑梗塞２５ｍｍ以上的病灶占多数。ＭＳ与脑梗塞组，有４个以上病灶的例数分别为９１％、８７％，两组无差异。卵圆形病灶，边缘清晰、光滑、高信号强度均匀一致病灶，与侧脑室相连接病灶，长轴与侧脑室壁相垂直病灶、胼底体病灶，脑干及小脑病灶等项目，在ＭＳ远多于脑梗塞组。然而，长轴平行于侧脑室病灶、主要分布于大脑灰质的病灶（占全病灶面积为５０％以上），在脑梗塞多于ＭＳ，两组有极显著差异（Ｐ＜００１）。结论：４个以上长轴５～１５ｍｍ的多发性小灶性病灶，边缘清晰、光滑、信号均匀一致病灶，与侧脑室壁相垂直病灶，卵圆形病灶，胼底体、脑干、小脑病灶为ＭＳ的ＭＲＩ病灶特征；长轴平行于侧脑室的病灶及主要分布于大脑灰质的病灶为脑梗塞ＭＲＩ病灶特征。
Objective: To investigate the characteristics and identification of MRI lesions of multiple sclerosis (MS) and cerebral infarction. Methods: The size, number, distribution and morphology of brain MRI lesions in clinically diagnosed MS228 cases and cerebral infarction cases 162 were analyzed. Results: In the long axis of MS 5 ~ 15mm lesions are more, more than 25mm in cerebral infarction lesions accounted for the majority. MS and cerebral infarction group, there are more than 4 cases of lesions were 91%, 87%, no difference between the two groups. Oval lesions, clear edge, smooth, high signal intensity uniform lesions, connected with the lateral ventricle lesions, long axis and lateral ventricular wall vertical lesions, lesions of the basal ganglia, brainstem and cerebellum lesions and other projects in the far More than cerebral infarction group. However, the long axis was parallel to the lesion in the lateral ventricle and mainly distributed in the gray matter of the brain (accounting for more than 50% of the total lesion area). There were more cerebral infarctions than MS, with significant differences between the two groups (P <001). CONCLUSIONS: More than 4 long-axis and multi-focal lesions of 5-15 mm in length are characterized by clear and smooth margins, uniform signal lesions, vertical lesions with lateral ventricular wall, oval lesions, corpus basalis, brainstem and cerebellum lesions MS features of MRI lesions; long axis parallel to the lateral ventricle lesions and mainly distributed in the brain gray matter lesions of cerebral infarction MRI lesions.