三维增强T_2*加权血管成像量化多发性硬化脑铁沉积的研究  

Quantitative Measurement of Iron Deposition in Multiple Sclerosis by Enhanced T_2 Star Weighted Angiography Abstract

作　　者：黄可忻 刘衡[1] 吴应行 宋赣军 詹剑[2] 吴博[1] 骆科进[1] 张体江[1] 

机构地区：[1]遵义医学院附属医院影像科,贵州省医学影像中心,563003 [2]遵义医学院附属医院神经内科

出　　处：《临床放射学杂志》2016年第6期842-847,共6页Journal of Clinical Radiology

基　　金：贵州省科学技术基金资助项目(编号:黔科合J字LKZ[2012]22号)

摘　　要：目的探讨三维增强T_2*加权血管成像(ESWAN)相位值(phase)及有效横向弛豫率值(R_2*)对多发性硬化(MS)患者深部灰质核团铁沉积的诊断价值,并分析测量值与扩展型残疾状态评分(EDSS)、病程相关性。方法22例临床确诊MS患者及与之性别、年龄及教育程度相匹配的22名健康对照组行常规MRI和ESWAN扫描。测量患者及对照组深部灰质核团(双侧丘脑、尾状核头、壳核、苍白球、红核、黑质)phase值及R_2*值。详细记录每例患者病程时间及EDSS评分。结果 (1)MS患者双侧深部灰质核团phase值均低于对照组,其中双侧尾状核头、壳核、红核及黑质与对照组比较差异具有统计学意义(P<0.05)。(2)MS患者双侧各个灰质核团R_2*均高于对照组,差异均具有统计学意义(P<0.05)。(3)MS患者各深部灰质核团phase值、R_2*值与EDSS评分、临床病程均无明显相关性(P>0.05)。结论 ESWAN序列多种测量值均能定量显示MS患者脑深部灰质核团明显铁质含量增多,有助于了解MS病理机制、研究颅内铁沉积与患者临床表现的相关性。Objective To quantificationally measure the phase value and R_2＊value in deep grey nuclei between multiple sclerosis patients and normal control by using Enhanced T_2 star weighted angiography,and to determine the correlation between iron deposition and clinical disability status scale,also to exploit a biomarker for monitoring the evolvement of disease.Methods 22 patients with MS,which was confirmed by clinical diagnosis and laboratory tests,22 age-matched normal control underwent brain scans using MRI.Bilateral phase value,and R_2＊value of head of caudate nucleus（HCN）,globus pallidus（GP）,putamen（PUT）,substantia nigra（SN）,red ucleus（RN） and thalamus（THA） were measured for MS patients and NC.Moreover,the correlations between there phase value and R_2＊values were measured,as well as EDSS scores and time of disease.Results（1） Compared with the NC,the mean phase values of bilateral deep gray nuclei generally decreased in the MS patients,and significant differences were observed in bilateral HCN,PUT,SN,RN（P 〈0.05）.Bilateral GP,THA had no significantcorrelation with controls（P 〈0.05）.（2） Compared to the NC,the mean R_2＊values for all the deep gray nuclei generally increased in the MS patients.Furthermore,the mean R_2＊values of all the deep gray nuclei were significantly higher than NC（P 〈0.05）.（3） There was no significant correlation between EDSS score and mean iron deposition of MS patients（P 〈0.05）.Conclusion ESWAN is a powerful tool for assessing iron deposition in brain.Because of the significant higher values in many deep gray nuclei,we consider that iron provides important information for pathogenesis and course of disease study for MS patients.

关 键 词：多发性硬化 磁共振成像 三维增强T2＊加权血管成像 脑深部灰质核团 铁沉积 

分 类 号：R445.2[医药卫生—影像医学与核医学] R744.51[医药卫生—诊断学]