小脑共济失调型多系统萎缩脑干白质定量DTT研究

Quantitative diffusion tensor imaging of MSA-C changes in brainstem white matter

目的:探讨小脑共济失调型多系统萎缩(MSA-C)患者脑干相关白质纤维的定量扩散张量纤维束成像特征。方法:搜集MSA-C型患者11例(MSA-C组)及健康志愿者11例(对照组),行常规MRI及扩散张量成像(DTI)检查,利用纤维束追踪成像法重建小脑上、中、下脚及锥体束,并测量其FA值和纤维条数。结果:MSA-C组小脑中脚、下脚及锥体束的FA值(0.458±0.019,0.372±0.010,0.494±0.016)较对照组(0.476±0.016、0.405±0.023、0.524±0.012)降低(P<0.05);小脑中脚、下脚及锥体束的纤维条数(373±76、72±23、173±35)较对照组(1544±156、116±37、311±94)降低(P<0.05)。MSA-C组小脑上脚的FA值(0.481±0.010)与对照组(0.474±0.012)比较差异无统计学意义(P>0.05);MSA-C组小脑上脚纤维条数(634±50)与对照组(686±117)比较差异无统计学意义(P>0.05)。结论:小脑中、下脚及锥体束的FA值和纤维条数的测量能从一个侧面反映MSA的病变特征。

Objective：To study the changes of quantitative diffusion tensor tractography （DTT） values of brainstem white matter in patients with multiple system atrophy-cerebellar ataxia （MSA-C）. Methods.. Conventional T2WI MRI and DTI were performed in 11 clinically proved MSA patients and 11 healthy volunteers. The superior cerebellar peduncle （SCP）,the middle cerebellar peduncle （MCP）,the inferior cerebellar peduncle （ICP） and pyramidal tracts （PT） were re- constructed. The fractional anisotropy （FA）, number of streamlines of SCP/MCP/ICP and PT were compared between groups. Results：In comparison with the control group,MSA-C decreased significantly in FA value of MCP （0. 458 ± 0. 019 and 0. 476±0. 016 respectively）, ICP（0. 372±0. 010 and 0. 405 ±0. 023 respectively）, PT （0. 494 ± 0. 016 and 0. 524 ± 0. 012 respectively） and also decreased in the number of streamlines of MCP（373 ±76 and 1544±156 respectively）, ICP （72±23 and 116±37 respectively）and PT （173±35 and 311±94 respectively,P〈0.05）. There were no significant differ- ences in FA value of SCP （0. 481±0. 010 and 0. 474±0. 012 respectively） and in the number of streamlines of SCP （634± 50 and 686 ±117 respectively） between MSA-C group and the control group （P〉0.05）. Conclusion.. The FA value and number of streamlines can sensitively reflect MCP,ICP and PT neural fiber pathological changes in MSA-C patients.