复发好转型多发性硬化表现正常脑白质DTI研究

Diffusion Tensor Imaging of the Normal-appearing White Matter in Relapsing-remitting Multiple Sclerosis

目的:利用扩散张量成像(DTI)直方图分析,明确复发好转型多发性硬化(RRMS)患者表现正常脑白质(NAWM)的异常改变及DTI直方图指标与扩展残疾状态(EDSS)评分的相关性。方法:对29例RRMS患者和35例健康志愿者行常规MRI和DTI检查,分割提取NAWM后,绘制出NAWM的平均扩散率(MD)和部分各向异性(FA)直方图,并对其进行分析。结果:与健康志愿者比较,RRMS患者NAWM平均MD直方图右移、峰高降低;平均FA直方图左移、峰高增高。RRMS患者NAWM的平均MD、MD直方图峰位置和FA直方图峰高明显高于健康志愿者(P<0.001),而MD直方图峰高和平均FA明显低于健康志愿者(P<0.001)。在RRMS患者,所有NAWM的MD和FA直方图指标与EDSS评分均无相关性。结论:RRMS患者NAWM内存在明显扩散异常。

Objective：To detect the abnormal changes in the normal-appearing white matter （NAWM） in patients with relapsing remitting multiple sclerosis （RPMS） by using diffusion tensor imaging （DTI） histogram analysis and to determine the correlations between DTI histogram measures and expanded disability status scale （EDSS） scores. Methods.. Conventional and DTI scans were performed in 29 patients with RRMS and 35 controls. After segmentation of the NAWM, the mean diffusivity （MD） and fractional anisotropy （FA） histograms of the NAWM were created and analyzed. Results： Compared with those of control subjects,the average MD histogram of the NAWM in RRMS patients shifted to the right with a lower peak height, while the average FA histogram of them shifted to the left with a higher peak height. The average MD,MD histogram peak location and FA histogram peak height were significantly higher than those of subjects in control group （P〈0.001）, while the MD histogram peak height and the average FA were significantly lower than those of control group （P〈0.001）. None of the MD and FA histogram measures of the NAWM of RRMS patients was correlated with EDSS scores. Conclusion： Patients with RRMS had overt abnormal diffusion in the NAWM.