一部分有明显脊髓症状而脊髓的MRI扫描却是阴性的病例,这给临床医师带来很大困扰,因此,而成为临床难题之一。本文综述国内外文献,从炎症、免疫、感染、缺血和遗传等诸多因素思考,结合不同的发病年龄,疾病背景和其他合并症状,进一步分析可以表现为痉挛性瘫痪而脊髓MRI扫描却表现为正常的脊髓病变的鉴别诊断,能够对这部分疑难脊髓病例的诊断和治疗选择提供帮助。目前,MRI新技术在脊髓病变中的应用,以及血液化学、细胞免疫与基因检测的进步也会给我们在脊髓病变诊断中带来新的希望。 Part of the spinal cord has obvious symptoms of spinal cord MRI scan is negative cases, which gives clinicians a lot of trouble, therefore, has become one of the clinical problems. This review summarizes literature from home and abroad, and considers many factors such as inflammation, immunity, infection, ischemia and heredity, combined with different age of onset, disease background and other combined symptoms. Further analysis can show spastic paralysis while spinal cord MRI shows The differential diagnosis of normal myelopathy can help diagnose and treat this difficult case of spinal cord. At present, the application of new MRI technology in myelopathy and the progress of blood chemistry, cellular immunity and genetic testing will also bring us new hope in the diagnosis of myelopathy.