肌萎缩侧索硬化症的磁共振成像及磁共振弥散张量成像研究  

A study on magnetic resonance conventional sequence imaging and magnetic resonance diffusion tensor imaging of amyotrophic lateral sclerosis

作　　者：王心宁[1] 吴志远[2] 缪飞[2] 肖勤[1] 陈生弟[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院神经内科,上海200025 [2]上海交通大学医学院附属瑞金医院放射科,上海200025

出　　处：《诊断学理论与实践》2009年第4期416-419,共4页Journal of Diagnostics Concepts & Practice

基　　金：上海市教育委员会科研创新项目(08zz60)

摘　　要：目的:研究肌萎缩侧索硬化症(ALS)患者皮质脊髓束磁共振成像(MRI)的常规序列图像和MRI弥散张量成像(DTI)特点。方法:对16例ALS患者(病例组)及16名健康志愿者(对照组)行MRI、DTI扫描,获取轴位、冠状位和矢状位图像,选取感兴趣区(ROI),测量部分各向异性分数(FA)和表观弥散系数(ADC)。使用ALS功能评定量表修订版(ALSFRS-R)评分与ALSAppel(AALSS)评分对其进行临床评估,分析影像学表现与年龄、病程及临床表现间的关系。结果:16例ALS患者中有11例(68.7%)T2加权成像(T2WI)、液体衰减反转回复序列(FLAIR)序列轴位及冠状位图像显示皮质脊髓束信号异常增高。与对照组比较,病例组中脑、内囊后肢3/4和半卵圆区ADC值升高(P<0.05),而中脑和内囊后肢3/4的FA值显著降低(P<0.01)。各ROI的FA值和ADC值与受检者的年龄、病程、ALSFRS-R评分、AALSS评分均无相关性。结论:MRI常规序列图像和DTI均能显示ALS患者的皮质脊髓束损害,而MRI常规序列对临床诊断可能具更重要的意义。Objective To investigate the characteristics of magnetic resonance conventional sequence imaging （MRI） and magnetic resonance diffusion tensor imaging （DTI） of corticospinal tract in patients with amyotrophic lateral sclerosis （ALS）. Methods MRI and DTI were performed in 16 ALS patients and 16 healthy controls. Axial, coronary and sagittal images were obtained and analyzed. Fractional anisotrophy （FA） and apparant diffusion coefficient （ADC） values of regionof-interest （ROI） were measured. ALS Functional Rating Scale-revised （ALSFRS-R） and Appel ALS Score （AALSS） were used for clinical assessment. The correlation of imaging characteristics with age, disease course and clinical parameters was analyzed. Results Of 16 ALS patients, 11 （68.7%） had marked elevation of corticospinal tract signal in axial and coronary images of T2 weighted imaging （T2W1） and fluid attenuated inversion recovery （FLAIR） imaging. ADC values in the midbrain, the 3/4 posterior limb of internal capsule （PLIC） and the centrum ovale were elevated （P〈0.05）, and FA values in the midbrain and the 3/4 PLIC were reduced （P〈0.01） in ALS patients when compared with healthy controls. No significant correlation of FA value and ADC value in various ROIs with age, disease course, ALSFRS-R score and AALSS score was found. Conclusions MRI conventional sequence imaging and DTI imaging both can demonstrate the involvement of corticospinal tract in ALS patients. MRI conventional sequence imaging may be more helpful in the clinical diagnosis of ALS.

关 键 词：肌萎缩侧索硬化症 皮质脊髓束 磁共振 弥散张量 诊断 

分 类 号：R744.8[医药卫生—神经病学与精神病学]