胼胝体扩散指标对鉴别复发性视神经脊髓炎和复发好转型多发性硬化的价值  

Differentiate relapsing neuromyelitis optica from relapsing-remitting multiple sclerosis using diffusion indices of the corpus callosum

作　　者：于春水[1] 李坤成[1] 朱朝喆[2] 秦文[1] 孙红[3] 陈彪[3] 

机构地区：[1]首都医科大学宣武医院医学影像学部放射科,北京100053 [2]北京师范大学认知神经科学与学习国家重点实验室,北京100875 [3]首都医科大学宣武医院医学影像学部神经内科,北京100053

出　　处：《中国医学影像技术》2006年第7期967-970,共4页Chinese Journal of Medical Imaging Technology

基　　金：北京市自然科学基金(NO.7042026);北京市优秀人才培养专项经费资助项目

摘　　要：目的研究胼胝体扩散指标对鉴别复发性视神经脊髓炎(RNMO)和复发好转型多发性硬化(RRMS)的价值。方法对110例复发性脱髓鞘病患者行常规MRI和DTI检查,从中选择诊断明确的RNMO患者26例和RRMS患者31例进行分析。以正中矢状面分数各向异性(FA)图上的胼胝体作为感兴趣区(ROI),分别测量该ROI的平均扩散率(MD)、FA、最大本征值(λ1)和横向本征值(λ2-3),并将其作为分类指标,观察这些指标对鉴别RNMO和RRMS的效果。结果RNMO患者胼胝体的MD、FA、λ1和λ2-3与RRMS患者明显不同(P<0.001)。通过选取恰当的分类阈值(MD=9.31×10-4mm2/s,FA=0.685;λ2-3=4.98×10-4mm2/s),利用胼胝体的MD、FA和λ2-3可将这两组患者区分开,分类准确性分别达到92.98%,89.47%和91.23%。结论胼胝体扩散指标能够较为准确地鉴别RNMO和RRMS。Objective To investigate whether diffusion indices of the corpus callosum can differentiate relapsing neuromyelitis optiea （RNMO） from relapsing-remitting multiple sclerosis （RRMS）. Methods Conventional and diffusion tensor imaging （DTI） were performed in 110 patients with recurrent demyelinating diseases. From them, 31 patients were definitely diagnosed as RRMS and 26 patients as RNMO. The mean diffusivity （MD）, fractional anisotropy （FA）, primary eigenvalue （λ.1 ）, and transverse eigenvalues （λ2-3） from the region of the corpus eallosum on the mid-sagittal FA image were measured and taken as the discriminative indices. The performance of these indices for differentiating RNMO from RRMS was observed. Results The average MD, FA, λ1 and λ2-3 of the corpus eallosum of RRMS patients were significantly different from those of RNMO patients （P〈0. 001）. RNMO patients could be discriminated from RRMS by choosing appropriate eut-offs （MD= 9.31 ×10-4 mm^2/s, FA= 0. 685; λ2-3 = 4.98 × 10-4 mm^2/s） of the corpus eallosum. The accuracy for this differential diagnosis was 92.98% for MD, 89.47% for FA and 91.23% for λ2-3, respectively. Conclusion Diffusion indices of the corpus eallosum can differentiate RNMO from RRMS.

关 键 词：视神经脊髓炎 多发性硬化 扩散张量成像 鉴别诊断 

分 类 号：R744.3[医药卫生—神经病学与精神病学] R744.51[医药卫生—临床医学]