Neurological Surgery 脳神経外科49巻2号

2021年03月発行

特集 脳神経画像Critical Findings—おさえておきたい症状とCT/MRI画像所見 Ⅳ脳腫瘍と鑑別すべき疾患

Tumefactive demyelinating lesion (TDL)

著者： 中島章博¹ 河内泉¹²

所属機関： ¹新潟大学脳研究所臨床神経科学部門脳神経内科学分野 ²新潟大学大学院医歯学総合研究科総合医学教育センター

ページ範囲：P.376 - P.382

Point
・Tumefactive demyelinating lesion（TDL）とは，2 cm以上の腫瘤様脱髄病変で，周囲への浮腫やmass effectを伴う中枢神経系炎症性病巣の総称である．
・TDLの背景病理には，多発性硬化症（MS），急性散在性脳脊髄炎（ADEM），視神経脊髄炎（NMOSD）などがある．
・近年では，MRI検査や自己抗体検査をはじめとした非侵襲的検査でTDLの背景病理を診断可能な場合もある．
・TDLを疑う場合，脳腫瘍や脳膿瘍などを除外し，TDLの背景にある病理・病態を確定する．TDLは診断プロセスを進めるために有用な臨床症候群名である．

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