复发-缓解型多发性硬化联络纤维定量DTI改变

Quantitative Diffusion Tensor Imaging of Association Fibers in RRMS

目的探讨复发-缓解型多发性硬化(RRMS)患者联络纤维定量扩散张量成像(DTI)改变。资料与方法选择低病灶负荷RRMS患者20例,年龄和性别相匹配的健康自愿者20名为对照进行MRI扫描,获取常规MRI图像和DTI图像,分别进行测量分析,比较RRMS患者和健康对照组联络纤维主要纤维束:上枕-额束、下枕-额束、钩束、下纵束、上纵束的部分各向异性指数(FA)值和平均扩散系数(MD)值的变化。结果 RRMS组患者钩束(L:F=5.498,P=0.024;R:F=5.158,P=0.029)、下纵束(L:F=8.267,P=0.007;R:F=5.108,P=0.03)、胼胝体/下枕-额束伴行部分(L:F=5.669,P=0.022;R:F=7.162,P=0.011)、下枕-额束/下纵束伴行部分(L:F=4.521,P=0.04;R:F=5.437,P=0.025)的FA值较健康对照组低,差异有统计学意义;RRMS组患者下纵束(L:F=5.012,P=0.031;R:F=5.48,P=0.025)、下枕-额束/下纵束伴行部分(L:F=8.318,P=0.006;R:F=12.882,P=0.00094)、胼胝体/下枕-额束伴行部分(L:F=5.426,P=0.025;R:F=5.8,P=0.021)的MD值较健康对照组高,差异有统计学意义;RRMS组患者双侧钩束/下纵束伴行部分、双侧胼胝体/下枕-额束伴行部分、双侧上枕-额束、双侧上纵束的FA值(P:0.065～0.599)、MD值(P:0.075～0.327)和对照组比较差异均无统计学意义,RRMS组患者双侧钩束的MD值和对照组比较差异无统计学意义。结论 RRMS组钩束、下纵束、胼胝体/下枕-额束伴行部分、下枕-额束/下纵束伴行部分等区域定量DTI值改变,提示联络纤维上述白质纤维束存在结构改变,定量DTI检测可敏感反映RRMS表现正常联络纤维存在的微观病理改变。

Objective To describe the change of quantitative diffusion tensor imaging（DTI） values of association fibers in patients with relapsing remitting multiple sclerosis（RRMS）. Materials and Methods Twenty RRMS patients with lower lesion load,and 20 gender/age matched healthy persons were selected in the study. Conventional magnetic resonance imaging（cMRI） and DTI was performed,than fractional anisotropy（FA）/ mean diffusivity（MD） of the major fiber bundle in association fibers：superior fronto-occipital fasciculus（sfo）,inferior fronto-occipital fasciculus（ifo）,uncinate fasciculus（unc）,inferior longitudinal fasciculus（ilf）,superior longitudinal fasciculus（slf） were measured and differences between two groups were analyzed. Results In comparison with controls,the RRMS patients had diminished FA values in unc（L：F=5.498,P=0.024;R：F=5.158,P=0.029）, ilf（L：F=8.267,P=0.007;R：F=5.108,P=0.03）, cc/ifo（L：F=5.669,P=0.022;R：F=7.162,P=0.011）, ifo /ilf（L：F=4.521,P=0.04;R：F=5.437,P=0.025） and diminished MD values in ilf（L：F=5.012,P=0.031;R：F=5.48,P=0.025）, ifo/ilf（L：F=8.318,P=0.006;R：F=12.882,P=0.00094）, cc/ifo（L：F=5.426,P=0.025;R：F=5.8,P=0.021）. FA and MD values in other regions of association fiber bundle did not show any significant differences between two groups. Conclusion The results suggest that there may be pathology change in unc, ilf, cc/ifo, ifo/ilf in RRMS patients. The change of quantitative DTI values can help to determine the association fibers neural fiber bundle micro-pathology change in RRMS patients sensitively.