摘要
目的运用3.0 T MR扩散张量成像(DTI)技术探讨复发-缓解型多发性硬化(RRMS)和复发型视神经脊髓炎(RNMO)患者脑深部核团的DTI指标是否存在差异,以及该指标与临床残疾评分(EDSS)是否存在相关性。方法用3.0 T MR分别对RRMS患者(MS组)、RNMO患者(NMO组)及健康志愿者(对照组)各30名进行脑部DTI扫描,分别测量脑深部核团的平均扩散率(MD)和部分各向异性分数(FA),并分析所得结果与临床评分的相关性。统计学分析采用单因素方差分析、Dunnett-t检验、Spearman相关分析、配对t检验等。结果 (1)MS组与对照组比较:前者丘脑(t=0.239,P=0.002)和黑质(t=0.667,P=0.016)的MD值升高,苍白球(t=-0.057,P=0.002)和齿状核(t=-0.052,P=0.012)的FA值降低;NMO组与对照组比较:前者红核的MD值升高(t=-0.034,P=0.034),差异有统计学意义;MS组与NMO组比较,两者壳核的FA值差异显著(t=-0.339,P=0.034)。(2)分析各指标同EDSS评分的相关性,结果 EDSS评分与丘脑(r=0.26,P=0.045)和黑质(r=0.329,P=0.01)MD值呈正相关,与FA值无显著相关性(P>0.05)。结论 MS和NMO患者灰质均有受累,壳核对鉴别MS与NMO具有潜在的应用价值,其FA值可作为监测MS及NMO临床进展的重要生物学指标。
Objective To explore the changes of brain deep nuclei in patients with relapsing-remitting multiple sclerosis （RRMS） and relapsing neuromyelitis optica （RNMO） using diffusion tensor imaging （DTI） and to analyze the correlations between DTI indexes and clinical Expanded Disability Status Scale （EDSS）. Methods 30 patients with MS （MS group）, NMO （NMO group） and healthy volunteers （control group） were imaged using DTI on a 3.0 Tesla scanner, re- spectively. DTI of brain deep nuclei from all participants were measured, including mean diffusivity （MD） and fractional anisotropy （ FA）, and the correlations between the DTI results and EDSS scores were assessed. One-way ANOVA, Dunnett- t test, Spearman correlation analysis, and Paired Sample T tests were used for statistics. Results （ 1 ） Compared with the control group ： MD values of both thalamus and substantia nigra were increased （ t was 0. 239 and 0. 667, respectively. P 〈 0.05）, and FA of both globus pallidus and dentate nucleus were decreased （t was - 0. 057 and - 0.052, respectively. P 〈 0.05） for MS group; MD values of red nucleus were increased （t = - O. 034, P = 0. 034） for NMO group. For MS group and NMO group, however, there were significant differences for FA of putamen （t = - 0. 339, P = 0. 034）. （2） Univariate correlations between DTI measures and the average EDSS scores were assessed ： MD values of both thalamus and substantia nigra showed positive correlations with EDSS scores （r was 0.26 and 0. 329, and P was 0. 045 and 0.01, re-spectively）, and FA had no correlation with EDSS scores. Conclusion There are gray matter damage in patients with MS and NMO. Putamen can provide a potential value of distinguishing MS and NMO, and its FA values may be useful quantita-tive biomarkers for monitoring the evolution of MS and NMO.
出处
《临床放射学杂志》
CSCD
北大核心
2013年第5期612-616,共5页
Journal of Clinical Radiology
基金
国家自然科学基金项目(编号:81171309)
重庆市自然科学基金(编号:CSTC2011JJA1073)
重庆市卫生局医学重点课题(编号:2011-1-031)
关键词
多发性硬化
视神经脊髓炎
扩散张量成像
Multiple sclerosis
Neuromyelitis optica
Diffusion tensor imaging
