肌萎缩侧索硬化的神经影像学研究  

Neuroimaging in Amyotrophic Lateral Sclerosis

作　　者：仇建婷[1] 任桂茹[1] 商秀丽[1] 

机构地区：[1]中国医科大学附属第一医院神经内科,辽宁沈阳110001

出　　处：《医学临床研究》2012年第1期1-4,共4页Journal of Clinical Research

基　　金：[基金项目]国家自然科学基金资助项目（81100243）,辽宁省教育厅科研项目（L2010564）,辽宁省科技厅科学技术计划项目（2011225020）

摘　　要：[目的]研究肌萎缩侧索硬化（ALS）的颅脑核磁共振成像（MRI）改变与临床表现的关系,分析ALS的颅脑弥散张量成像（DTI）特点,评价MRI及DTI在ALS诊断中的价值.[方法]对49例ALS患者的临床和影像学资料进行回顾性分析,颅脑MRI呈现皮质脊髓束（CST）异常改变者构成MRI阳性组,共10例,无异常改变者构成MRI阴性组,共39例;此外,对1例患者的DTI及弥散张量纤维束成像（DTT）结果进行单独分析.[结果]MRI阳性者共10例（占20.4%）;MRI阳性组的起病年龄较MRI阴性组小,且两组相比较差异有显著性（ P 〈0.01）,锥体束征较MRI阴性组明显（ P 〈0.01）;两组的病程相比较无统计学差异（ P 〉0.05）;DTI显示CST等广泛纤维束的各向异性值（FA）减低,DTT示CST严重缺失.[结论]虽然颅脑MRI呈现异常改变与ALS临床表现有一定关系,但在临床诊断ALS的患者中,MRI阳性率较低,可见MRI对ALS并不敏感,仅作为参考标准,而DTI技术可能对ALS的诊断有所帮助,有待进一步研究.[Objective]To explore the relationship between the change of cerebral magnetic resonance ima- ging（MRI） and the clinical manifestation of amyotrophic lateral sclerosis（ALS）, analyze the cerebral diffusion tensor imaging（DTI） and evaluate the value of MRI and DTI in the diagnosis of ALS. [Methods]The clinical and imaging data of 49 ALS patients were analyzed retrospectively. Ten patients with abnormal change of cor- ticospinal tract（CST） by cerebral MRI were selected as MRI-positive group（ n = 10）. Thirty-nine patients without abnormal change of CST were selected as MRI-negative group. In addition, the results of DTI and dif- fusion tensor tractography （DTT） in a patient were analyzed alone. [Results]There were 10 MRI-positive pa- tients（20.4%）. The age of onset in MRI-positive group was younger than that in MRI-negative group, and there was significant difference（ P 〈0.01）. The pyramid sign in MRI-positive group was more obviously than that in MRI-negative group（P〈0.01）. There was no statistical difference in duration of illness between two groups（ P〉0.05）. DTI showed that the anisotropy（FA） values in extensive fiber tracts involving CST de- creased. DTT showed that CST had severe deletion. [Conclusion]Although there is correlation between the abnormal change of cerebral MRI and clinical manifestation of ALS, the positive rate of MRI for clinical diag- nosis of ALS patients is lower. It indicates that MRI is not sensitive to ALS and only taken as the reference standard. However, DTI may be helpful for the diagnosis of ALS and should be further studied.

关 键 词：肌萎缩侧索硬化/放射摄影术 神经放射摄影术 

分 类 号：R746.4[医药卫生—神经病学与精神病学]