多发性硬化的非均匀磁化传递成像研究

Study of inhomogeneous magnetization transfer imaging in multiple sclerosis

目的评价非均匀磁化传递(ihMT)成像诊断多发性硬化(MS)的价值。方法对18例临床诊断为MS的患者及16名健康志愿者行ihMT成像,测量并比较MS患者白质内病灶与健康志愿者白质区磁化传递率(MTR)、量化磁化传递值(qMT)、非均匀磁化传递率(ihMTR)和非均匀量化磁化传递值(qihMT)的差异,并采用 Spearman 相关分析评价MS患者ihMT成像参数与临床扩展致残量表评分(EDSS)的相关性。结果 MS病灶的MTR、qMT、ihMTR、qihMT均低于健康志愿者脑白质(P均<0.001);MTR、qMT与EDSS呈中等负相关(r=-0.440、-0.572,P=0.004、0.002),ihMTR、qihMT与EDSS呈强负相关(r=-0.704、-0.739,P均<0.001)。结论 ihMTR和qihMT值能准确反映白质髓鞘含量的变化,且与MS临床症状相关性好,具有较好的临床应用前景。

Objective To observe the value of inhomogeneous magnetization transfer (ihMT) imaging in diagnosis of multiple sclerosis (MS).Methods Totally 18 patients with clinical diagnosed MS and 16 healthy volunteers were enrolled.ihMT imagings were obtained,while magnetic transfer ratio (MTR),quantitative magnetization transfer (qMT) value,inhomogeneous magnetization transfer ratio (ihMTR) and inhomogeneous quantitative magnetization transfer (qihMT) value of MS lesions and normal white mater of volunteers were measured,respectively.ihMT metrics were compared between MS patients and volunteers.Spearman correlation was conducted to analyze the correlation of MTR,qMT,ihMTR and qihMT values and clinical expanded disability status scale (EDSS) for MS patients.Results MTR,qMT,ihMTR and qihMT of MS patients were significantly lower than those of volunteers (all P<0.001).There was moderate negative correlation between MTR,qMT and EDSS (r=-0.440,-0.572,P=0.004,0.002),also significant negative correlation between ihMTR,qihMT and EDSS (r=-0.704,-0.739,both P<0.001).Conclusion ihMTR and qihMT values are sensitive to detect the changes of myelin content and have good correlation with clinical symptoms,therefore having good prospects for clinical application.