多发性硬化患者胼胝体分区MRI形态及脑白质束成像的定量研究  

Quantitative study of corpus callosum segmentation MRI topology and brain white matter tractography in patients with multiple sclerosis

作　　者：胡冰[1] 康庄[1] 骆众星[1] 邝思驰[1] 王劲[1] 单鸿[1] 

机构地区：[1]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》2014年第6期604-609,共6页Chinese Journal of Neuromedicine

基　　金：国家自然科学基金（81000513）;广东省科技计划项目（20118031800256）

摘　　要：目的观察多发性硬化（MS）患者胼胝体分区MRI形态及脑白质束成像表现，评估其定量结果与扩充致残量表（EDSS）评分的相关性。方法中山大学附属第三医院放射科自2011年6月至2013年6月对32例MS患者（MS组）和32例健康自愿者（对照组）进行MRI常规扫描和扩散张量成像（DTI）扫描，测量胼胝体各分区（1～5区）及总胼胝体的面积、平均扩散程度（ADC）值、各向异性（FA）值、脑白质束数目，并应用t检验比较2组间差异，同时使用Pearson线性相关分析评估MS组患者上述指标定量结果与其EDSS评分的相关性。结果经脑白质束成像可以直观地发现MS患者胼胝体各分区脑白质束存在不同程度的破坏。MS组胼胝体各分区的面积、FA值、脑白质束数目均明显小于对照组，胼胝体1～3区的ADC值明显大于对照组，差异均有统计学意义（P〈0．05）；MS组总胼胝体的面积）（549．13±64．07）mm^2]、FA值（0．55±0．05）、脑白质束数目（519．78±79．03）均明显小于对照组[（614．56±39．67）mm^2、0．67±0．02、612．34±39．51]，ADC值[（0．93±0．09）×10^-3mm^2／s]明显大于对照组[（0．86±0．03）×10^-3mm^2／s]，差异均有统计学意义（P〈0．05）。MS组胼胝体各分区的面积、脑白质束数目均与EDSS评分呈负相关关系（P〈0．05）；MS组总胼胝体的面积、脑白质束数目均与EDSS评分呈负相关关系（r=-0．686，P=-0．000；r=-0．676，P=0．000）。结论胼胝体各分区及总胼胝体的面积、脑白质束数目可反映MS患者临床症状的严重程度，其检测可用于MS患者的病情评估和疗效评价。Objective To observe the quantitative corpus callosum （CC） segmentation MRI topology and brain white matter tractography variations in patients with multiple sclerosis （MS）, and to assess the correlation between quantitative indicators and scores of expanded disability status scale （EDSS）. Methods Conventional MRI and diffusion tensor imaging （DTI） were applied in 32 MS patients and 32 healthy volunteers, admitted to our hospital from June 2011 to June 2013. The areas, average diffusion coefficent （ADC） values, fractional anisotropy （FA） values and tracked lines of each CC segment （1-5） and total CC were measured. T tests were used to compare the above quantitative indices in MS patients with those in controls. Linear regression model was used to determine the relationship between quantitative indices and scores of EDSS in MS patients. Results Various degrees of damage of white matter tracts in CC of MS patients could be visually identified by tractography. The areas, FA values and tracked lines of each CC segment in MS patients were smaller than those in controls （P〈0.05）, and the ADC values of segment 1-3 in MS patients were larger than those in controls （P〈0.05）. Moreover, the areas （[549.13±64.07] mm^2）, FA values （0.55±0.05） and tracked lines （519.78±79.03） of total CC in MS patients were smaller than those in controls （[614.56±39.67] mm^2, [0.67±0.02] and [612.34±39.51],P〈0.05）, and the ADC values （[0.93±0.09]×10^3 mm^2/s） of total CC in MS patients were larger than those in controls （[0.86±0.03]×10^3 mm^2/s, P〈0.05）. Both areas and tracked lines of each CC segment in MS patients had negative correlations with EDSS scores （P〈0.05）. Moreover, both areas and tracked lines of total CC in MS patients were found having negative correlations with EDSS scores （r=-0.686, P=0.000; r=-0.676, P=-0.000）. Conclusion Both areas and tracked lines of each CC segment and total CC reflect the degrees of clinical disability in MS patients,

关 键 词：多发性硬化 胼胝体 磁共振成像 扩散张量成像 脑白质束成像 

分 类 号：R445.1[医药卫生—影像医学与核医学] R744.51[医药卫生—诊断学]