多发性硬化斑块周围正常表现白质的磁敏感加权成像及动态磁敏感增强灌注成像  

Susceptibility-weighted imaging and dynamic susceptibility contrasted MR perfusion imaging of normal-appearing white matter around plaques in multiple sclerosis

作　　者：苗延巍[1] 魏强[1] 韩睿[1] 张竞文[1] 郎志谨[1] 

机构地区：[1]大连医科大学附属第一医院放射科,大连116011

出　　处：《磁共振成像》2011年第4期273-277,共5页Chinese Journal of Magnetic Resonance Imaging

摘　　要：目的通过定量测量多发性硬化(MS)患者白质斑块周围"正常表现白质"(normal-appearing white matter,NAWM)脑铁浓度和灌注参数来评估其微循环变化与铁沉积的关系。方法 31例MS患者进行MR检查,包括磁敏感加权成像(susceptibility-weightedi maging,SWI),部分患者(15例)加做动态磁敏感增强灌注成像(dynamic susceptibility contrasted MR perfusion imaging,DSC-PI)。30名年龄相匹配的健康志愿者作为对照组也进行SWI检查。观察MS斑块在SWI的表现;以配对t检验对照分析MS患者NAWM与对照组白质phase值和灌注参数(rCBF、rCBV和rMTT);对MS患者NAWM的phase值与灌注参数(rCBF、rCBV和rMTT)、扩展型残疾状态评分(expanded disability status scale,EDSS)进行Pearson相关回归分析。结果 MS斑块在"滤过后"相位图(filtered phase image,FPI)多呈有或无小静脉穿行的低信号灶。MS患者NAWM的phase值显著低于对照组(P<0.05);而双顶叶phase值与EDSS有显著中度相关(右侧:r2=0.36,P=0.03;左侧:r2=0.48,P=0.02);双额、顶叶的phase值与其rCBF值也存在明显相关(P<0.05)。结论 MS患者NAWM的phase值显著低于正常人,与微循环血流及EDSS具有相关性,可以一定程度上反映病情的变化。.Objective：To determine the correlation between iron deposit and perfusion by quantificationally measuring the phase value and perfusion indices in normal-appearing white matter（NAWM） in multiple sclerosis（MS） patients.Materials and Methods：Thirty-one clinically proven MS cases were performed with susceptibility-weighted imaging（SWI） and dynamic susceptibility contrasted MR perfusion imaging（DSC-PI）.Thirty age-matched healthy volunteers were participated in this study as a control.Features of MS plaques in filtered phase images（FPI） were first assessed.The measurements of phase values and perfusion parameters（including CBF and CBV） were taken and compared by using paired t test,and the correlations between phase values and perfusion parameters,as well as phase values and EDSS was respectively evaluated by using Pearson correlative analysis.Results：In 31 cases of MS,the round or oval hypointense foci with or without small veins were considered as the characteristic finding of MS plaques.In comparison with the controls,the phase values of NAWM surrounding MS plaques were significantly lower in the MS group（P0.05）.Pearson correlation analysis revealed a significant correlation between the phase values of bilateral parietal NAWM and EDSS（P0.05）.As for the bilateral parietal and frontal NAWM,their phase values also significantly correlated with the rCBF（P0.05）.Conclusion：The phase values of NAWM in the MS patients varied with the cerebral perfusion,which also correlated with the EDSS,and could be used to evaluate the course changes of MS patients.

关 键 词：多发性硬化 正常表现白质 磁共振成像 磁敏感加权成像 灌注 

分 类 号：R445.2[医药卫生—影像医学与核医学] R744.51[医药卫生—诊断学]