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目的:探讨多发性硬化(MS)早期常规MR扫描表现正常的胼胝体的磁共振弥散张量成像(DTI)的改变。方法:20例病程相对较短(平均2.3年)的MS患者和20个年龄性别相匹配的健康志愿者为对照进行MR扫描,获取高分辨常规MRI(T1WI、T2WI、FLAIR)图像及DTI图像,获得表现正常胼胝体(NACC)和额、枕部表现正常白质(NAWM)的部分各向异性指数(FA)值和平均扩散系数(MD)值。结果:早期MS患者的NACC与正常对照比较,其FA值显著下降(P<0.001)、MD值显著增加(P<0.001);早期MS患者额、枕部的NAWM和正常对照比较,其FA值(P=0.216)、MD值(P=0.673)差异均无统计学意义。NACC的平均MD值和反映脑实质中央性萎缩的Evans指数间存在相关性(r=0.648,P=0.043)。结论:定量磁共振弥散张量值(FA值和MD值)的变化表明MS疾病早期损害优先出现在胼胝体,胼胝体的结构特点可能是其在MS早期易受损害的重要原因。定量DTI可用于监控和评估早期MS患者NACC的改变和预后。
Objective: To investigate the changes of magnetic resonance diffusion tensor imaging (DTI) of the corpus callosum, which showed normal MR scan in early stage of multiple sclerosis (MS). Methods: 20 patients with relatively short duration (average 2.3 years) of MS and 20 age-matched healthy volunteers were used as controls to perform MR scanning. High resolution conventional MRI (T1WI, T2WI, FLAIR) images and DTI images were obtained. Partial anisotropy (FA) values and mean diffusivity (MD) values of normal corpus callosum (NACC) and normal and white matter occipital (NAWM) were obtained. Results: Compared with the normal control, the NACC in early MS patients decreased significantly (P <0.001) and the MD value increased significantly (P <0.001). Compared with the normal controls, (P = 0.216), MD value (P = 0.673), there was no significant difference. There was a correlation between the mean MD of NACC and the Evans index reflecting atrophy of central parenchyma (r = 0.648, P = 0.043). CONCLUSION: The changes of quantitative magnetic resonance diffusion tensor values (FA values and MD values) indicate that the early lesions of MS disease preferentially appear in the corpus callosum. The structural features of the corpus callosum may be an important reason for its susceptibility to damage in the early stages of MS. Quantitative DTI can be used to monitor and assess NACC changes and prognosis in patients with early stage MS.