| 刘亚欧,于春水,李坤成,林富春,段云云,秦文,王辉.临床孤立综合征和复发缓解型多发性硬化MR弥散张量成像的对比研究[J].中国医学影像技术,2008,24(7):996~1000 |
| 临床孤立综合征和复发缓解型多发性硬化MR弥散张量成像的对比研究 |
| Comparative study of magnetic resonance diffusion tensor imaging in clinically isolated syndrome and relapsing-remitting multiple sclerosis |
| 投稿时间：2007-10-26 修订日期：2008-05-19 |
| DOI： |
| 中文关键词: 临床孤立综合征 多发性硬化,复发缓解性 弥散张量成像 磁共振成像 |
| 英文关键词:Clinically isolated syndrome Multiple sclerosis, relapsing-remitting Diffusion tensor imaging Magnetic resonance imaging |
| 基金项目:北京市自然科学基金资助项目(7042026)。 |
|
| 摘要点击次数: 2971 |
| 全文下载次数: 918 |
| 中文摘要: |
| 目的 探讨MS最早期阶段即CIS是否已存在可被DTI发现的异常改变及其严重程度,揭示其可能反映的病理改变,与临床状态的关系,从而更加深入认识CIS与MS的关系。方法 选择19例CIS患者、19例临床确诊的RRMS患者和19例性别、年龄与之匹配的健康志愿者为研究对象。用1.5T超导型磁共振扫描仪采集数据,包括常规T1WI、T2WI、DTI,经后处理得到:T2WI上病灶的体积、平均弥散率及各向异性分数,全脑(WB)、表现正常脑组织(NABT)的平均弥散率、各向异性分数直方图,其中提取出下列指标:平均值、直方图峰高和峰位置。应用社会统计软件包(SPSS 11.5)对以上观察内容进行统计学分析。结果 CIS与RRMS患者病灶体积、平均弥散率、平均各向异性分数均无显著性差异。WB及NABT平均弥散率正常对照组、CIS组、RRMS组依次增高,平均各向异性分数正常,对照组、CIS组、RRMS组依次减低,且均有显著性差异(P＜0.05),NABT平均弥散率图峰高正常对照组、CIS组、RRMS组依次降低,平均各向异性分数图峰位置正常,对照组、CIS组、RRMS组依次左移,且均有显著性差异(P＜0.05)。CIS患者各项DTI指标与扩展残疾状态量表评分均无显著性相关。RRMS患者病灶平均分数各向异性(r=-0.566,P=0.012)、WB的平均弥散率(r=0.497,P=0.030)、NABT的平均弥散率(r=0.692,P=0.001)与EDSS评分存在显著性相关关系。结论 本研究表明DTI可以敏感的显示CIS及MS全脑病变,作为MS最早期表现的CIS患者全脑包括病灶、NABT均已发生了病理改变,但其病灶与MS比较无显著性差异,而NABT的严重程度较MS轻微。 |
| 英文摘要: |
| Objective To investigate whether normal appearing brain tissue (NABT) abnormalities occur in patients with clinically isolated syndrome (CIS) and how serious it is comparing to multiple sclerosis (MS), and to find the relationships between DTI indices of lesions, NABT and clinical status to reveal the possible pathologic mechanisms and offer evidences for treatment. Methods Ninteen patients with CIS, 19 clinically diagnosed relapsing-remitting MS patients and 19 sex- and age-matched healthy volunteers were chosen as subjects. Images were obtained using Siemens 1.5T magnetom sonata scanner, including conventional MRI and DTI. The volume, mean diffusivity (MD) and fractional anisotropy (FA) of lesions, DTI histograms of whole brain, NABT were obtained. The mean value, peak height, peak location of the histogram were used for analysis. All data were statistically processed with SPSS for Windows (version 11.5). Results No significant differences were found in the brain volume, DTI indices of lesions among control, CIS and RRMS. Comparing with control, CIS patients showed significantly higher whole brain and NABT average MD, lower FA (P＜0.05), however, which is lower in average MD and higher in FA than RRMS (P＜0.05). The peak height of NABT average MD histogram was significantly lower in CIS than control (P＜0.05), but higher than RRMS. The peak location of NABT average FA histogram in RRMS, CIS and control was from left to right (P＜0.05). There was no correlations between DTI indices and EDSS scores in patients with CIS. Moderate correlations between lesion FA (r=－0.566, P=0.012), average MD in whole brain (r=0.497, P=0.030), NABT (r=0.692, P=0.001) were found in patient with RRMS. Conclusion Whole brain contains lesion and NABT abnormalities do occur in CIS which can be detected by DTI sensitively. The lesions are similar with MS, however, the underlying pathological changes in NABT are milder than MS. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
|
|
|
