扩散张量成像对多发性硬化脑深部灰质核团纵向定量研究  

Longitudinal Quantitative Study of Brain Deep Nuclei in Patients with Multiple Sclerosis By Using Diffusion Tensor Imaging

作　　者：熊华[1] 李咏梅[1] 侯焕新[1] 曾春[1] 王静杰[1] 杜思霖[1] 孟奔[1] 

机构地区：[1]重庆医科大学附属第一医院放射科,400016

出　　处：《临床放射学杂志》2015年第1期2-6,共5页Journal of Clinical Radiology

基　　金：国家自然科学基金项目(编号:81371523);重庆市卫生局重点课题(编号:2011-1-031;2012-1-017);国家临床重点专科

摘　　要：目的利用3.0 T MR扩散张量成像(DTI)技术纵向定量测量复发-缓解型多发性硬化(RRMS)患者脑深部灰质核团相关参数的动态变化及其与临床相关性。方法选取RRMS患者30例及健康对照组30名,检查前根据临床残疾状态量表(EDSS)对患者进行评分。患者行间隔平均时间约2年共2次常规MRI及DTI检查,必要时行增强扫描。选取测量大脑深部灰质核团的部分各向异性分数(FA)值及平均扩散率(MD)值,比较两次测量结果的变化并评价与临床的相关性。结果 (1)与对照组相比患者脑深部部分灰质核团FA值降低,MD值增高;(2)分析各指标与EDSS评分的相关性,结果 EDSS评分与丘脑(r=0.25,P=0.04)和黑质(r=0.27,P=0.046)MD值呈正相关,与丘脑(r=0.24,P=0.03)、尾状核(r=0.414,P=0.024)FA值呈负相关性。(3)患者前后两次参数对比各核团的FA值无明显变化(P>0.05),但尾状核(t=2.36,P=0.013)、丘脑(t=3.01,P=0.009)、黑质(t=2.35,P=0.015)、红核(t=2.50,P=0.012)等核团MD值增高,以丘脑增高最明显。结论 DTI能够提示RRMS患者脑深部灰质核团受累,并且在纵向观测中可以监测患者深部灰质的病理改变。Objective By using diffusion tensor imaging （DTI） longitudinal quantitatie measurement with a 3.0 T MR scanner to investigate the dynamic changes of related parameters of brain deep gray nuclei in patients with multiple sclerosis （RRMS）, and to analyze the correlations between DTI indexes and clinical expended disability status scale （EDSS）. Methods Thirty patients with RRMS （study group） and 30 healthy volunteers （control group） were recruited. Pretreat- ment EDSS evaluation was performed in all subjects. Two times of conventional MRI and DTI scans with the mean interval of about two years were carried out in all subjects, and additional enhanced was employed when it was necessary. The frac- tional anisotropy （FA） and the mean diffusivity （MD） of brain deep nuclei were measured, the differences in FA and MD between the two results were compared and the correlations between the DTI results and EDSS scores were analyzed. Re- suits （ 1 ） Compared with the control group, in the study group the FA values of the brain deep nuclei were decreased, while the MD values were increased. （2） Univariate correlations between DTI measures and the average EDSS scores were assessed, the results indicated that MD values of both thalamus and substantia nigra bore a positive correlation with EDSS scores （r = 0. 25, P = 0.04 and r = 0. 27, P = 0. 046 respectively）, while FA values of both thalamus and caudate nucleus bore a negative correlation with EDSS scores （ r = 0. 24, P = 0.03 and r = 0. 414, P = 0.024 respectively）. （ 3 ） No signifi- cant changes in FA values of the deep nuclei existed between the two parameters determined before and after （P 〉 0.05）, but the MD values were significantly increased in the caudate nucleus （t = 2. 36, P =0.013）, the thalamus （t = 3.01, P =0.009）, the substantia nigras （t = 2. 35, P = 0.015 ） and the red nucleus （t = 2. 50, P = 0.012） ; the increase in MD value of the thalamus was the most obvious. Conclusion DTI can reveal the

关 键 词：多发性硬化 扩散张量成像 纵向研究 

分 类 号：R744.51[医药卫生—神经病学与精神病学]