目的: 探究磁共振成像(megnetic resonace image, MRI)结合血液生化标志物对多发性硬化的临床诊断价值。方法: 选取2023年1月-2024年9月收治的30例多发性硬化患者为观察组,按病情程度分成轻症组(18例)、重症组(12例),同期健康体检者50例为对照组,比较观察组与对照组两组患者的血液生化标志物水平;观察组患者进行MRI检查后,分析多发性硬化患者的MRI影像学特征,应用受试者特征工作曲线(receiver operating characteristic curve, ROC)分析MRI联合生化标志物对多发性硬化的诊断价值。结果: (1)30例多发性硬化症患者MRI检查发现135个病理改变区域,主要病变分布于脑干、侧脑室周边、小脑和脑白质;(2)MRI平扫病变表现为T1低信号,T2和FLAIR序列为高信号,侧脑室周围病变垂直于长轴;MRI冠状位和矢状位平扫T2显示高信号,呈多空间分布;(3)观察组患者血清神经特异性烯醇化酶(neuron-specific enolase, NSE)、髓鞘碱性蛋白(myelin basic protein, MBP)和血清S100B蛋白(serum S100 calcium-binding protein B, S100B)水平高于对照组(P＜0.05),重症组患者的血清NSE、S100B水平均高于轻症组(P＜0.05)。(4)ROC曲线分析显示MRI联合生化标志物对多发性硬化的灵敏度、特异度、准确度分别为87.50%、93.75%、91.25%,高于单独使用MRI和生化标志物指标的灵敏度、特异度、准确度。结论: 血液生化标志物结合MRI检测,不仅能够显示出多发性硬化的病灶,且有助于提高该疾病的诊断价值。

Objective: To explore the clinical diagnostic value of magnetic resonance imaging (MRI) combined with blood biochemical markers in multiple sclerosis. Methods: Thirty patients with multiple sclerosis admitted from January 2023 to September 2024 were selected as the observation group. According to the severity of the disease, they were divided into mild group (18 patients) and severe group (12 patients). At the same time, 50 healthy subjects were selected as the control group. The levels of blood biochemical markers in the observation group and the control group were compared. After MRI examination, the MRI imaging features of patients with multiple sclerosis were analyzed. The receiver operating characteristic curve (ROC) was used to analyze the diagnostic value of MRI combined with biochemical markers for multiple sclerosis. Results: (1) 135 pathological changes were found in 30 patients with multiple sclerosis by MRI, and the main lesions were distributed in brainstem, periventricular, cerebellum and white matter. (2) MRI plain scan showed low signal in T1, high signal in T2 and FLAIR sequences, and the lesions around the lateral ventricle were perpendicular to the long axis. MRI coronal and sagittal plain scan T2 showed high signal, showing multiple spatial distribution. (3) The levels of serum neuron-specific enolase (NSE), myelin basic protein (MBP) and serum S100 calcium-binding protein B (S100B) in the observation group were higher than those in the control group (P＜0.05). The levels of serum NSE and S100B in the severe group were higher than those in the mild group (P＜0.05). (4) ROC curve analysis showed that the sensitivity, specificity and accuracy of MRI combined with biochemical markers for multiple sclerosis were 87.50%, 93.75% and 91.25%, respectively, which were higher than those of MRI and biochemical markers alone. Conclusion: Blood biochemical markers combined with MRI detection can not only show the lesions of multiple sclerosis, but also help to improve the diagnostic value of the disease.