多发性硬化患者MRI扩散张量成像脑白质束示踪的三维仿真定量研究  

Quantitative 3D simulation research of MRI diffusion tensor white matter fiber tractography in patients with multiple sclerosis

作　　者：杨洋[1] 康庄[2] 邹艳[2] 邝思驰[2] 单鸿[1] 胡冰[1] 

机构地区：[1]中山大学附属第三医院信息科,广州510630 [2]中山大学附属第三医院放射科,广州510630

出　　处：《中华神经医学杂志》2011年第10期1048-1052,共5页Chinese Journal of Neuromedicine

基　　金：国家自然科学基金（81000513）;中山大学CAI基金（820001163145）

摘　　要：目的研究多发性硬化（MS）患者脑白质束示踪的三维仿真影像表现，评价其定量结果与残疾状态扩展评分（EDSS）的相关性。方法对28例MS患者（MS组）和28名健康自愿者（对照组）通过MRI扩散张量成像扫描进行脑白质束示踪，测量示踪纤维数和示踪纤维密度，并应用配对t检验比较两组间差异；对MS组脱髓鞘斑块、正常表现脑白质和对照组感兴趣区的ADC值和FA值进行方差分析，使用线性回归模型计算MS组脑白质束示踪的定量结果与EDSS评分的相关性。结果在MS组脑白质束示踪三维仿真图像中可直接观察到脑白质束的受损和减少。MS组的示踪纤维数（2220±100）和踪纤维密度（0．75±0．04）明显低于对照组（2750±70、0．93±0．02），差异有统计学意义（P〈0．05）。MS组脱髓鞘斑块、正常表现脑白质和对照组感兴趣区的ADC值依次下降，分别为（1．23±0．13）×10^-3mm2／s、（0．76±0．09）×10^-3mm2／s、（0．63±0．10）×10^-3mm2／s；FA值依次升高，分别为0．24±0．04、0．42±0．07、0．48~0．06，差异均有统计学意义（P〈0．05）。MS组示踪纤维数和示踪纤维密度都与EDSS评分呈负相关关系（r=-0．782，P=-0．000；r==-0．771，P=-0．000）。结论通过MRI扩散张量成像扫描进行脑白质束示踪可以发现MS患者脑白质束的受损情况．其较常规MRI能提供更多的空间信息。Objective To study the quantitative fiber tractography variations and 3D simulation patterns in patients with multiple sclerosis （MS）, and assess the correlation between quantitative fiber tractography and scores of expanded disability status scale （EDSS）. Methods MR diffusion tensor imaging was applied in 28 MS patients and 28 age-matched healthy volunteers. Then, quantitative tractography was generated in all subjects; and mean numbers of tracked lines and fiber density were measured. Paired-samples t tests were used to compare tracked lines and fiber density in MS patients with those in controls. Analysis of variance of ADC value and FA value was applied to MS patients having demyelinating plaque and normal appearing white matter, and controls. Linear regression model was used to determine the relationship between quantitative fiber tractography and scores of EDSS in MS patients. Results Tractography＇s tracked lines （2220±100） and fiber density （0.75±0.04） in MS patients were less than those in controls （2750±70） and （0.93±0.02, P〈0.05）. In MS patients having plaque and normal appearing white matter, and controls, the ADC values of ROI were （1.23±0.13）×10^-3mm2/s, （0.76±0.09）×10^-3mm2/s and （0.63±0.10）×10^-3mm2/s, respectively, with a gradual declined trend; and the FA values were 0.24±0.04, 0.42±0.07 and 0.48±0.06, respectively, with a gradual increased trend; significant differences were noted between each 2 groups （P〈0.05）. Both tracked lines and fiber density were found negative correlations with scores of EDSS in MS patients （P〈0.05）. Conclusion Damages of white matter tracts in MS patients can be detected by diffusion tensor fiber tractography, and it provide more space information than conventional MRI.

关 键 词：脑白质束示踪 多发性硬化 磁共振成像 扩散张量成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]