复发缓解型多发性硬化患者脑白质氧化应激状态的在体MRI研究  

In vivo MRI study of the oxidative stress level in the white matter of patients with relapsing-remitting multiple sclerosis

作　　者：廖荟珽 蔡子萌 叶海琪 陈骞蓝 侯明佳 蔡克家 陈唯唯 Liao Huiting;Cai Zimeng;Ye Haiqi;Chen Qianlan;Hou Mingjia;Cai Kejia;Chen Weiwei(Department of Radiology,Tongji Hospital,Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430030,China;Department of Radiology,Guangdong Provincial People′s Hospital,Guangdong Academy of Medical Sciences,Guangzhou 519041,China;Department of Radiology,Hangzhou First People′s Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China;Experimental and Clinical Research Centre,Max Delbrück Centre for Molecular Medicine and Charité-Universitätsmedizin Berlin,Corporate Member of Freie Universität Berlin,Humboldt-Universität zu Berlin,and Berlin Institute of Health,Berlin 13092,Germany;Department of Radiology,University of Illinois Hospital&Health Science System,Chicago 60612,USA)

机构地区：[1]华中科技大学同济医学院附属同济医院放射科,武汉430030 [2]广东省医学科学院广东省人民医院放射科,广州519041 [3]浙江大学医学院附属杭州市第一人民医院放射科,杭州310003 [4]Experimental and Clinical Research Centre,Max Delbrück Centre for Molecular Medicine and Charité-Universitätsmedizin Berlin,Corporate Member of Freie Universität Berlin,Humboldt-Universität zu Berlin,and Berlin Institute of Health,Berlin 13092 [5]Department of Radiology,University of Illinois Hospital&Health Science System,Chicago 60612

出　　处：《中华放射学杂志》2023年第6期640-646,共7页Chinese Journal of Radiology

摘　　要：目的探讨质子交换速率(k_(ex))成像技术研究复发缓解型多发性硬化(RRMS)患者脑白质病灶(WML)及表观正常脑白质(NAWM)的氧化应激状态的价值。方法回顾性分析2018年11月至2021年11月在华中科技大学同济医学院附属同济医院就诊的RRMS患者(病例组)37例的临床及影像资料,其中男11例、女26例,年龄18~41(29±7)岁。另招募同期年龄段相匹配的健康志愿者22名(对照组),其中男4名、女18名,年龄23~44岁,中位年龄25(24,28.25)岁。所有受检者均接受MR常规序列及化学交换饱和转移成像,并定性评估k_(ex) map上WML的位置和数量,WML的T1WI图像信号特征;定量分析病例组WML、NAWM和对照组正常脑白质(NWM)的k_(ex)值。采用成组t检验或独立样本t检验比较病例组WML与NAWM、病例组NAWM与对照组NWM以及T1WI呈低信号和等信号WML的k_(ex)值,采用Spearman秩相关分析WML的k_(ex)值与患者扩展残疾状态量表(EDSS)评分的相关性。结果病例组37例患者中共发现272个WML,其中25.4%(69/272)的WML在T1WI图像上呈明显低信号。病例组WML的k_(ex)值[(932±108)s-1]高于NAWM[(771±26)s-1],差异有统计学意义(t=8.95,P<0.001);病例组NAWM的k_(ex)值[(771±26)s-1]高于对照组NWM[(745±26)s-1],差异有统计学意义(t=3.96,P<0.001)。在T1WI呈低信号WML的k_(ex)值[(1039±110)s-1]高于呈等信号WML的k_(ex)值[(895±79)s-1],差异有统计学意义(t=9.78,P<0.001)。相关性分析显示,病例组WML的k_(ex)值与EDSS评分呈正相关(r=0.54,P<0.001)。结论RRMS患者NAWM和WML的k_(ex)值升高,反映氧化应激水平升高,且与组织损伤程度正相关,说明氧化应激不仅参与了RRMS脑白质病灶的形成还与全脑病变相关。Objective To explore the oxidative stress of cerebral white matter lesion(WML)and normal-appearing white matter(NAWM)with in vivo proton exchange rate(k_(ex))MRI on relapse-remitting multiple sclerosis(RRMS)patients.Methods Clinical and imaging data of 37 patients(case group)with RRMS patients of Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology were analyzed retrospectively from November 2018 to November 2021,including 11 males and 26 females aged 18-41(29±7)years.Another 22 age-matched healthy volunteers(control group)were recruited for the same period,including 4 males and 18 females aged 23-44 years with a median age of 25(24,28.25)years.All subjects received conventional MR protocols and chemical exchange saturation transfer imaging.The manifestation of WML on the k_(ex) map and T1WI images were assessed while the k_(ex) values of WML,NAWM and normal white matter(NWM)of control group were quantitatively evaluated.Student′s t test was used to compare the k_(ex) difference of WML and NAWM in the case group,NAWM in the case group and NWM in the control group,low-signal and isosignal WML in T1WI.Spearman rank correlation was used to analyze the correlation of the k_(ex) values of WML with patients′expanded disability status scale(EDSS)score.Results A total of 272 WML were found in the 37 RRMS patients,and 25.4%(69/272)were T1-hypointense.The k_(ex) value of WML in the case group[(932±108)s-1]was higher than that of NAWM[(771±26)s-1],and the difference was statistically significant(t=8.95,P<0.001);the k_(ex) value of NAWM in the case group[(771±26)s-1]was higher than that of NWM[(745±26)s-1]in the control group,and the difference was statistically significant(t=3.96,P<0.001).The k_(ex) value[(1039±110)s-1]of WML with low signal at T1WI was higher than that of WML with equal signal[(895±79)s-1],with a statistically significant difference(t=9.78,P<0.001).Correlation analysis showed that the k_(ex) value of WML in the case group was positively correlated with the E

关 键 词：多发性硬化 磁共振成像 脑白质病灶 表观正常脑白质 质子交换率 氧化应激 

分 类 号：R744.51[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]