视神经脊髓炎和多发性硬化患者颈髓扩散张量成像研究  

A comparative study of cervical cord diffusion tensor imaging between multiple sclerosis and neuromyelitis optica patients

作　　者：黄靖[1] 刘亚欧[1] 段云云[1] 任卓琼[1] 李坤成[1] 刘峥[2] 董会卿[2] 叶静[2] 陈海[2] 

机构地区：[1]首都医科大学宣武医院放射科,北京100053 [2]首都医科大学宣武医院神经内科,北京100053

出　　处：《中国现代神经疾病杂志》2014年第10期861-866,共6页Chinese Journal of Contemporary Neurology and Neurosurgery

基　　金：国家自然科学基金重点资助项目(项目编号:30930029);国家自然科学基金青年科学基金资助项目(项目编号:81101038);北京市卫生局青年科学研究资助项目(项目编号:QN2010-01)~~

摘　　要：目的通过扩散张量成像（DTI）比较视神经脊髓炎和多发性硬化患者与正常对照者常规MRI表现正常脊髓的扩散性差异,并探讨其临床应用价值。方法采用平面回波成像技术对10例视神经脊髓炎、14例多发性硬化患者和13例正常对照者进行颈髓DTI检查,分别测量颈椎C2-5水平前索、侧索、后索和灰质兴趣区的部分各向异性（FA）和平均扩散率（MD）。结果与正常对照组相比,视神经脊髓炎组患者前索、侧索、后索FA值降低（均P〈0.05）,左侧侧索、后索、灰质MD值升高（均P≤0.05）;多发性硬化组患者右侧侧索、后索FA值降低（均P〈0.05）。与多发性硬化患者相比,视神经脊髓炎患者侧索FA值更低,左侧侧索和右侧后索MD值更高（均P〈0.05）。结论 DTI可以检出视神经脊髓炎和多发性硬化患者常规MRI表现正常脊髓的水分子扩散异常,进而发现二者脊髓扩散指标的差异性,为早期诊断与鉴别诊断提供重要信息。Objective To assess the diffusion changes of normal appearing spinal cord（NASC） inMRI examination in patients with neuromyelitis optica（NMO） and multiple sclerosis（MS）.Methods Axial diffusion tensor imaging（DTI） of cervical cord was performed in 10 patients with NMO, 14 patientswith MS and 13 sex- and age-matched healthy controls. Mean diffusivity（MD） and fractional anisotropy（FA） were measured in the C2-5level of spinal cord. Regions of interest（ROIs） were placed in the anterior,lateral, posterior funiculi of spinal cord, and the central gray matter of spinal cord.ResultsComparedwith healthy controls, the values of FA in anterior, lateral and posterior funiculi of spinal cord weresignificantly decreased（P〈0.05, for all） and MD in left lateral funiculus, posterior funiculus and graymatter were significantly increased（P ≤ 0.05, for all） in NMO group, and the FA values of right lateral andposterior funiculi in MS group were significantly decreased（P〈0.05, for all）. Compared with MS group, FAvalue in patients with NMO was significantly decreased in lateral funiculus, and MD value in left lateraland right posterior funiculi were significantly increased（P〈0.05, for all）.ConclusionsNASC diffusionabnormalities were found both in patients with NMO and MS. The difference of DTI indicators betweenNMO and MS patients may offer important information in the early diagnosis and differential diagnosis ofNMO and MS.

关 键 词：视神经脊髓炎 多发性硬化 磁共振成像 

分 类 号：R744.51[医药卫生—神经病学与精神病学]