多发性硬化白质损伤和灰质病变研究及相关性分析  

Study on white cerebral matter damage and gray matter disease of multiple sclerosis and correlation analysis

作　　者：朱敏[1] 尹燕伟[1] 韦洁如 孙继平[1] 巩晓艳[1] 宋先东[2] 

机构地区：[1]牡丹江医学院附属红旗医院影像科,黑龙江牡丹江157011 [2]牡丹江医学院附属红旗医院骨外二科,黑龙江牡丹江157011

出　　处：《中国现代医生》2017年第11期65-67,共3页China Modern Doctor

基　　金：黑龙江省卫生计生委科研课题(2014-192)

摘　　要：目的观察多发性硬化患者脑白质及灰质的病变特点和相关性。方法选取2016年3~9月我院收治的多发性硬化(RRMDS)患者30例为观察组,30例志愿者为对照组,身体健康,与观察组年龄相匹配,均采用3.0T核磁共振点分辨波谱(Philips Achieva,荷兰)及扩散张量成像(DTI),同时使用基于体素的形态学技术(VBM)及基于纤维束示踪的空间统计法(TBSS),明确脑白质破坏后的意义及改变与患者脑灰质改变特点。结果观察组患者脑白质纤维束广泛性FA值减低,与对照组比较,差异有统计学意义(P<0.05);患者灰质体积较对照组减少;观察组患者灰质萎缩部位VBM体素大小与白质联络纤维FA值呈正相关,拟合度较好,差异有统计学意义(P<0.05)。结论观察组患者全脑白质纤维束广泛性损伤,患者灰质的萎缩与白质损伤关系密切,尤其与联络纤维的损伤相关。Objective To observe the pathological features and correlation of white matter and gray matter in patients with multiple sclerosis. Methods Thirty patients with multiple sclerosis（RRMDS） admitted in our hospital from March to September 2016 were selected as observation group, and 30 volunteers who were healthy and matched with the age of the observation group were chosen as control group.. All the patients were given 3.0T nuclear magnetic resonance point resolution spectroscopy （Philips Achieva, Holiand） and Diffusion Tensor Imaging （DTI）. At the same time, voxel-based morphological techniques （VBM） and tract-based spatial statistics were used to define the meaning and change of white matter after destruction, and the change characteristics of patients with brain gray matter. Results The FA value of white matter fibers in the observation group was extensively decreased, and the difference between the observation group and control group was statistically significant （P〈0.05）. The gray matter volume of the patients in the observation group was lower than that of the control group. There was a positive correlation between the size of VBM voxels in the gray matter atrophy site and the FA value of white matter contact fibers in the observation group, and the fitting degree was good, with statistically significant difference （P〈0.05）. Conclusion The patients in the observation group have ex- tensive damage in the whole white matter fiber bundle. The atrophy of gray matter in patients is closely related to white matter damage, especially related to the damage of the contact fibers.

关 键 词：多发性硬化 脑白质损伤 脑灰质病变 相关性 

分 类 号：R744.51[医药卫生—神经病学与精神病学]