| 尹平,刘义,周津如,时晓清,曾春,王静杰,刘梦奇,罗天友,吕发金,李咏梅.动态对比增强磁共振成像观察复发缓解型多发性硬化微循环改变[J].中国医学影像技术,2016,32(7):1010~1014 |
| 动态对比增强磁共振成像观察复发缓解型多发性硬化微循环改变 |
| Dynamic contrast-enhanced MRI for microvascular abnormality in patients with relapsing-remitting multiple sclerosis |
| 投稿时间：2015-11-30 修订日期：2016-03-03 |
| DOI：10.13929/j.1003-3289.2016.07.004 |
| 中文关键词: 动态对比增强磁共振 Tofts模型 多发性硬化 直方图 |
| 英文关键词:Dynamic contrast-enhanced magnetic resonance imaging Tofts model Multiple sclerosis Histogram |
| 基金项目:国家自然科学基金资助项目（81371523）、国家临床重点专科建设项目（［2013］544）、重庆市卫生局资助项目（2011-1-031、2012-1-017） |
| 作者 | 单位 | E-mail | | 尹平 | 重庆医科大学附属第一医院放射科, 重庆 400016 | | | 刘义 | 重庆医科大学附属第一医院放射科, 重庆 400016 | | | 周津如 | 重庆医科大学附属第一医院放射科, 重庆 400016 | | | 时晓清 | 重庆医科大学附属第一医院放射科, 重庆 400016 | | | 曾春 | 重庆医科大学附属第一医院放射科, 重庆 400016 | | | 王静杰 | 重庆医科大学附属第一医院放射科, 重庆 400016 | | | 刘梦奇 | 重庆医科大学附属第一医院放射科, 重庆 400016 | | | 罗天友 | 重庆医科大学附属第一医院放射科, 重庆 400016 | | | 吕发金 | 重庆医科大学附属第一医院放射科, 重庆 400016 | | | 李咏梅 | 重庆医科大学附属第一医院放射科, 重庆 400016 | lymzhang70@aliyun.com |
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| 中文摘要: |
| 目的 应用动态对比增强磁共振成像（DCE-MRI）分析复发缓解型多发性硬化（RRMS）病灶的渗透、灌注及直方图参数及其与临床评分的相关性。方法 对27例RRMS患者行常规MRI和DCE-MRI检查并应用Tofts模型进行后处理，定量分析MS患者病灶及看似正常白质（NAWM）的容积转移常数Ktrans、脑血流量（CBF）和脑血容量（CBV），并与临床扩展残疾状态量表（EDSS）评分及病程进行相关性分析。结果 ①强化病灶的Ktrans值明显高于非强化病灶、病灶旁NAWM及远离病灶NAWM（χ2=24.771，P<0.001）；非强化病灶的Ktrans值明显高于病灶旁NAWM与远离病灶NAWM（P均<0.05）。②强化病灶的CBF、CBV明显高于非强化病灶及NAWM，但非强化病灶的CBF、CBV与病灶旁、远离病灶NAWM的差异均无统计学意义（P均>0.05）。③直方图结果显示非强化病灶的偏度值与强化病灶的差异无统计学意义，但后者分布更接近于正态分布；两者的峰度值均低于正态分布的峰值。④Ktrans、CBF、CBV与EDSS评分及病程均无相关性（P>均0.05）。结论 DCE-MRI结合Tofts模型可显示MS病灶及NAWM的微血管渗透及灌注异常，直方图可能对MS不同病灶类型的鉴别具有一定的帮助。 |
| 英文摘要: |
| Objective To quantification of the permeability, perfusion and histogram parameters and its correlation with expanded disability status scale (EDSS) and disease duration in relapsing-remitting multiple sclerosis (RRMS) using dynamic contrast-enhanced MRI (DCE-MRI). Methods Totally 27 patients with clinically definite RRMS underwent the conventional MRI and the DCE-MRI. Postprocessing was performed by using a Tofts model. The imaging biomarkers were quantitatively measured, including volume transfer constant (Ktrans), cerebral blood flow (CBF) and cerebral blood volume (CBV) of the lesions and normal-appearing white matter (NAWM) regions. The correlation between imaging biomarkers and EDSS and disease duration were also analyzed. Results ①The Ktrans of contrast-enhancing (CE) lesions were significantly higher than that of nonenhancing (NE) lesions and the NAWM regions both near and far from NE lesions (all P<0.001). The Ktrans of NE lesions were significantly higher than that of NAWM regions (P<0.05). ②The CBF and CBV of CE lesions were significantly higher than NE lesions and the NAWM regions both near and far from NE lesions (all P<0.001). ③The histogram parameters showed that the skewness coefficient of NE lesions had no significant differences with CE lesions, but the latter were more close to normal distribution. The kurtosis prompts that the peak of MS lesions were lower than that of normal distribution. ④The Ktrans, CBF and CBV were not significantly correlated with EDSS and disease duration (both P>0.05). Conclusion The DCE-MRI combined with Tofts model can be used to show the microvascular permeability, perfusion characteristic and the hemodynamic abnormalities of the lesions and NAWM in patients with RRMS. Moreover, the histogram may be helpful to distinguish different MS lesions. |
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