复发-缓解型多发性硬化脑白质微结构改变及临床功能的相关性  

Correlation between white matter microstructural changes and clinical function in patient with relapsing-remitting multiple sclerosis

作　　者：张艳 尹义 杨丽铭 黄明明 余晖 ZHANG Yan;YIN Yi;YANG Liming;HUANG Mingming;YU Hui(Department of Radiology,the Affiliated Hospital of Guizhou Medical University,Guiyang 550004,China;School of Medical Imaging,Guizhou Medical University,Guiyang 550004,China;Department of Radiology,Dermatology Hospital of Southern Medical University,Guangzhou 510091,China)

机构地区：[1]贵州医科大学附属医院影像科,贵州贵阳550004 [2]贵州医科大学医学影像学院,贵州贵阳550004 [3]南方医科大学皮肤病医院影像科,广东广州510091

出　　处：《实用放射学杂志》2025年第1期9-12,57,共5页Journal of Practical Radiology

摘　　要：目的探讨复发-缓解型多发性硬化(RRMS)患者脑白质微结构改变及其与临床功能评分的相关性。方法选取RRMS患者20例(RRMS组)和健康对照(HC)20例(HC组)并进行扩散张量成像(DTI)和扩展残疾状况量表(EDSS)评分,RRMS根据EDSS评分分为MS-1组(运动功能障碍伴视觉障碍)和MS-2组(运动障碍)。应用基于纤维束示踪的空间统计分析(TBSS)进行图像处理。组间比较采用t检验,相关分析采用Spearman相关。结果RRMS组大钳、小钳、双侧扣带束、双侧钩束、双侧上纵束、双侧下纵束、双侧下额枕束、双侧皮质脊髓束、双侧丘脑前辐射各向异性分数(FA)值降低伴平均扩散率(MD)值、径向扩散率(RD)值升高;大钳、小钳、双侧上纵束(颞部)、右侧下额枕束、双侧皮质脊髓束、右侧丘脑前辐射轴向扩散率(AD)值升高。MS-1组相比MS-2组右侧扣带束(扣带回部)FA值及左侧扣带束(扣带回部)AD值升高。相关分析显示RRMS组大钳、右侧上纵束FA值与运动功能评分呈负相关,小钳、右侧上纵束、右侧下额枕束、左侧皮质脊髓束MD值及小钳、右侧扣带束(海马部)、右侧上纵束、左侧皮质脊髓束RD值与运动功能评分呈正相关。结论RRMS患者存在脑白质微结构损害且与运动功能障碍相关,为RRMS患者运动功能障碍的病理机制提供了影像学支持。Objective To investigate the microstructural changes of white matter in patients with relapsing-remitting multiple sclerosis(RRMS)and its correlation with clinical functional scores.Methods A total of 20 patients with RRMS(RRMS group)and 20 healthy controls(HC)(HC group)were selected and underwent diffusion tensor imaging(DTI)and expanded disability status scale(EDSS)scores.Patients with RRMS were categorized into two groups based on their EDSS scores,including MS-1 group(motor dysfunction with visual impairment)and MS-2 group(motor dysfunction).Image processing was performed via tract-based spatial statistics(TBSS).Group comparisons were executed using the t-test,while correlations were analyzed utilizing Spearman correlation.Results In the RRMS group,reduced fractional anisotropy(FA)values were accompanied by increased mean diffusivity(MD)and radial diffusivity(RD)values in the forceps major,forceps minor,bilateral cingulum,bilateral uncinate fasciculus,bilateral superior longitudinal fasciculus,bilateral inferior longitudinal fasciculus,bilateral inferior fronto-occipital fasciculus,bilateral corticospinal tract and bilateral anterior thalamic radiation compared with the HC group.Additionally,In the RRMS group,increased axial diffusivity(AD)values were noted in the forceps major,forceps minor,bilateral superior longitudinal fasciculus(temporal),right inferior frontooccipital fasciculus,bilateral corticospinal tract and right anterior thalamic radiation compared with the HC group.Compared with the MS-2 group,the MS-1 group exhibited higher FA values in the right cingulum(cingulate gyrus part)and higher AD values in the left cingulum(cingulate gyrus part).Correlation analysis revealed negative correlations between the FA values of the forceps major,right superior longitudinal fasciculus and the motor function scores in RRMS group.Conversely,positive correlations were identified between the MD values of the forceps minor,right superior longitudinal fasciculus,right inferior fronto-occipital fasciculus,left cortic

关 键 词：多发性硬化 扩散张量成像 脑白质 

分 类 号：R742[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]