磁敏感加权成像纵向观察复发-缓解型多发性硬化患者脑深部灰质核团铁沉积  

Longitudinal ESWAN observation on iron deposition in the deep nucleus in patients with relapse-remitting multiple sclerosis

作　　者：黄富洪[1] 李咏梅[1] 吕发金[1] 欧阳羽[1] 侯焕新[1] 曾春[1] 王静杰[1] 

机构地区：[1]重庆医科大学附属第一医院放射科,重庆400016

出　　处：《中国医学影像技术》2012年第9期1632-1636,共5页Chinese Journal of Medical Imaging Technology

基　　金：重庆市卫生局资助项目(2010-1-004;2011-1-031);重庆市自然科学基金(CSTC2011JJA1073);国家自然科学基金(81171309)

摘　　要：目的利用3.0T MR 3D磁敏感加权成像(ESWAN)技术纵向观察复发-缓解型多发性硬化(RRMS)患者脑深部灰质核团铁沉积的动态变化及其与临床的相关性。方法选取RRMS患者30例,间隔2年进行2次ESWAN及常规MR检查。结合轴位及矢状位T2FLAIR图像,观察病灶的变化,并将其分为病灶增加组(n=15)、无变化组(n=9)和病灶减少组(n=6)。测量脑深部灰质核团的平均相位值(MPVs),比较ROI内铁含量的变化及与临床的相关性。结果与第1次相比,第2次检查结果中,除丘脑的相位值无明显变化外,其余各核团的相位值均降低,以黑质的变化最为显著(t=2.92,P=0.007)。病灶增加组及无变化组各核团的相位值均减低,病灶增加组各核团相位值降低幅度相对较大,其中以黑质的相位值降低最明显(t=5.40,P=0.001)。在病灶减少组,除齿状核的相位值降低外,其余核团的相位值均增加。在复发次数<2次的患者中,各核团的相位值变化均无统计学意义(P>0.05);而在复发次数≥2次的患者中,除丘脑(P=0.212)、苍白球(P=0.891)外,其余各核团的相位值变化均有统计学意义(P<0.05)。前、后2次EDSS评分之差与各核团相位值的变化之间均无相关性(P>0.05);除丘脑(r=0.332,P=0.073)外,病灶负荷与其余各核团相位值的变化间均明显相关(P<0.05)。结论 RRMS患者丘脑的铁含量相对稳定,其余深部灰质核团的铁含量变化与病灶的负荷相关。Objective To longitudinally assess the dynamic changes of iron content in the deep nucleus and the correlation with clinic in patients with relapse-remitting multiple sclerosis （RRMS） with 3D enhanced T2＊ weighted angiography （ES- WAN）. Methods Thirty patients with RRMS were recruited and underwent conventional MRI and ESWAN two times with the interval of 2 years. Combination of axial and sagittal T2 FLAIR image were performed to compare the changes of lesion between two times, and then the patients were divided into lesion increased group （n= 15）, unchanged group （n= 9） or decreased group （n= 6）. The mean phase values （MPVs） of deep hncleus were measured, and the changes of iron content and the correlation between the changes and clinic were analyzed. Results Compared with the findings of first time, the second examination showed that all the deep nucleus＇ MPVs declined except thalamus, and the changes in substantia nigra were most significant （t= 2.92, P= 0. 007）. In lesion load increased and unchanged group, all the deep nucleus＇ MPVs declined. The changes in lesion load increased group were more significant, and substantia nigra＇s MPVs decreased most pronouncedly （t= 5.40, P= 0. 001）. In lesion decreased group, all the deep nucleus＇ MPVs increased except dentate nucleus. No significant statistical difference of the change of MPVs was found in all deep nucleus in patients with relapse time less than twice （P〉0.05）, while in patients with relapse time greater than or equal to two times, the changes of MPVs in the deep nucleus was statistical obvious （P〈0.05） except thalamus （P= 0.212） and globus pallidus （P= 0. 891）. Correlation between the change of EDSS and the change of MPVs was not found （P〉0.05）, while lesion load was correlated with the changes of MPVs except thalamus （r=0. 332, P=0. 073）. Conclusion The content of iron in thalamus in patients with RRMS is stable, while other deep nucleus＇ changes of iron content correlate to lesion

关 键 词：多发性硬化 复发-缓解型 3D增强型T2*加权血管成像 铁沉积 纵向研究 

分 类 号：R445.2[医药卫生—影像医学与核医学] R74[医药卫生—诊断学]