多发性硬化脑深部灰质核团铁沉积的SWI定量研究

Quantitative measurement of iron deposition in the deep gray nuclei of multiple sclerosis by SWI

目的:通过相位值的测量定量评估多发性硬化(MS)脑深部灰质核团的铁含量。材料与方法:25例符合临床诊断标准的MS患者进行MR检查,尤其磁敏感加权成像(SWI),其中男11例,女14例,年龄21～58岁,平均(37.28±10.15)岁。根据临床分型,MS组又分为缓解-复发型MS(RR-MS)15例和继发进展型MS(SP-MS)10例。另外26名年龄、性别相匹配的健康志愿者作为对照组(男11例,女15例),进行同样的MR检查。测量每个MS患者和健康对照者双侧苍白球(GP)、壳核(PUT)、尾状核头(HCN)、黑质(SN)、红核(RN)以及丘脑(THA)的相位值,并在MS组和对照组之间、MS亚型之间进行对照研究。结果:与对照组相比,MS患者的双侧GP、PUT、HCN、SN、RN和THA的相位值均下降,但是只有双侧SN(左侧:1901.37±111.94,右侧:1909.78±128.99)和RN(左侧:1977.44±77.02,右侧:1973.52±76.80)的相位值降低有显著意义(P<0.05)。同时,SP-MS组的双侧GP相位值显著低于RR-MS组(P<0.05)。结论:SWI的相位值能够量化脑铁含量,有助于定量评估MS患者脑铁变化。

Objective：To quantitative assessment of brain iron deposition in the deep gray nuclei of multiple sclerosis（MS） by using susceptibility weighted imaging（SWI） technique.Materials and Methods：Twenty-five patients with clinically proven MS,which included 15 cases of released-remitting MS（RR-MS）,10 cases of secondary-progressive MS（SP-MS）,and 26 cases of age-matched healthy volunteers as controls,all had MR examination associated with SWI.Bilateral phase value of globus pallidus（GP）,putamen（PUT）,head of caudate nucleus（HCN）,substantia nigra（SN）,red nucleus（RN） and thalamus（THA） were measured and compared with those of healthy volunteers,and then with those of the MS subtypes.Results：Compared to the controls,the mean phase values in bilateral RN（left：1977.44±77.02,right：1973.52±76.80） and SN（left：1901.37±111.94,right：1909.78±128.99） were significantly higher（P0.05）.Whereas,no significant difference was present between the MS subjects and the controls in the bilateral CN,PUT,GP,THA and PUL other structures（P0.05）,although the mean phase values of these structures were slightly lower in the MS rather than in the controls.Furthermore,in contrast with the SP-MS,the significant variation of phase values in the RR-MS was only obtained in bilateral GP（P0.05）.Conclusion：As a powerful tool for quantifying brain iron,SWI can be helpful in evaluation abnormal iron accumulation in MS and further assessment processes of the disease.