复发-缓解型多发性硬化患者灰质灌注与体积改变的相关性及其临床价值  

Correlation Between Gray Matter Perfusion and Gray Matter Volume Change in Patients with Relapsing-remitting Multiple Sclerosis and Its Clinical Value

作　　者：顾瑶 付佳亮 陈晓娅 谢敏[1] 郑桥 孔丽娜 李咏梅[1] GU Yao;FU Jialiang;CHEN Xiaoya;XIE Min;ZHENG Qiao;KONG Lina;LI Yongmei(Department of Radiology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院放射科

出　　处：《中国医学影像学杂志》2019年第11期801-804,808,共5页Chinese Journal of Medical Imaging

基　　金：国家重点研发计划（2016YFC0107109）;重庆市科学技术委员会-重庆市基础研究与前沿探索专项（cstc2018jcyjAX0584）;重庆市卫生计生委医学科研计划项目（2016ZDXM002）;重庆市卫计委医学科研青年项目（2018QNXM004）

摘　　要：目的应用三维伪连续动脉自旋标记(3D pCASL)分析复发-缓解型多发性硬化(RRMS)患者灰质脑血流量(CBF)改变及其与灰质体积、临床扩展残疾状态量表(EDSS)及病程的相关性。资料与方法对31例RRMS患者和37名健康对照者(对照组)行常规MRI、3D pCASL及3D T1WI扫描,并应用Matlab平台的SPM 8和VBM 8软件分别对3D pCASL和3D T1WI图像进行预处理。首先分析RRMS组与对照组间灰质CBF改变;将灰质体积作为协变量,分析RRMS组与对照组间灰质CBF改变情况。进一步提取灰质灌注改变脑区的CBF值,并分析EDSS评分和病程的相关性。结果校正灰质体积前与对照组比较,RRMS组患者表现出多个脑区CBF下降(P<0.01,Alphasim多重比较校正,体素>93);校正灰质体积后与对照组比较,RRMS组患者上述CBF下降脑区仅右侧额上回、左侧三角部额下回、左侧枕中回差异有统计学意义(P<0.01,Alphasim多重比较校正,体素>73);RRMS组患者右侧额上回、左侧三角部额下回、左侧枕中回CBF与病程呈负相关(r_s=-0.501、-0.508、-0.473,P均<0.05),与EDSS均无显著相关性(P均>0.05)。结论RRMS患者存在广泛灰质灌注下降,其中存在与灰质体积萎缩无关的灌注改变,可为RRMS灰质灌注的病理改变提供更多影像学依据。Purpose To analyze the changes of cerebral blood flow(CBF)and gray matter volume(GMV)of patients with relapsing-remitting multiple sclerosis(RRMS)and its correlation with GMV,clinical extended disability status scale(EDSS)and course of disease through three-dimensional pseudo-continuous arterial spin labeling(3D pCASL).Materials and Methods Conventional MRI,3D pCASL and 3 D T1 WI scanning were performed to 31 patients with RRMS and 37 subjects of control group.Images were preprocessed by SPM 8 and VBM 8 software of Matlab.Values of CBF and GMV in RRMS group and control group were analyzed,then the GMV was used as covariate to analyze the changes in CBF and GMV in RRMS group and control group.The CBF value of cerebral area was altered by extracting gray matter perfusion,and correlation analysis was made to EDSS score and course of disease.Results Before changing GMV,CBF decreased in multiple brain regions(P<0.01,Alphasim multiple comparison correction,voxel>93)in RRMS group compared with control group.After changing GMV,the value differences of only the right superior frontal gyrus,left triangular part of the inferior frontal gyru and left middle occipital gyrus in CBF-decreased cerebral region in RRMS group compared with control group were statistically significant(P<0.01,Alphasim multiple comparison correction,voxel>73).The CBF of these values in these areas mentioned-above were negatively correlated with the course of RRMS(r_s=-0.501,-0.508,-0.473,P<0.05),but not significantly correlated with EDSS(P>0.05).Conclusion There is a common decrease of gray matter perfusion in RRMS group,and some perfusion changes were not related to gray matter volume atrophy,which can provide more imaging defining characteristics for the pathological changes through gray matter perfusion to treatment of RRMS.

关 键 词：多发性硬化 复发缓解型 磁共振成像 图像处理 计算机辅助 灰质 脑血管循环 血液灌注 病理过程 

分 类 号：R445.2[医药卫生—影像医学与核医学] R741.04[医药卫生—诊断学]