目的研究急性播散性脑脊髓炎 (ADEM)发病机制、临床表现、影像学特征 ,以提高本病诊治水平。方法对确诊的 41例 ADEM临床资料进行分析总结。结果本病发病机理与病毒感染、疫苗接种及非特异性感染导致的免疫反应有关 ;临床出现脑和脊髓多灶性、弥漫性损害症状 ,影像学显示有关部位相应病灶 ;激素治疗有效。结论符合文献报告 ,ADEM是一组广泛累及脑和脊髓的一种中枢神经系统炎症性脱髓鞘性疾病。早期诊断、及时治疗 ,尤其大剂量激素的应用 ,对改善病情、降低病死率大有益处 Objective To study the pathogenesis, clinical manifestations and imaging features of acute disseminated encephalomyelitis (ADEM) in order to improve the diagnosis and treatment of this disease. Methods The clinical data of 41 cases diagnosed by ADEM were analyzed and summarized. Results The pathogenesis of this disease was related to the immune response caused by virus infection, vaccination and nonspecific infection. The clinical manifestations of multifocal and diffuse lesions of the brain and spinal cord, the imaging showed the corresponding lesion in the relevant site, and the hormone therapy was effective. Conclusions In line with the literature, ADEM is a group of central nervous system inflammatory demyelinating diseases that have extensive involvement of the brain and spinal cord. Early diagnosis, timely treatment, especially the application of high-dose hormones, to improve the condition, reduce the mortality benefit