CAJ | 학술논문

目的研究多发性硬化(MS)患者脑白质束示踪的三维仿真影像表现,评价其定量结果与残疾状态扩展评分(EDSS)的相关性. 方法对28例MS患者(MS组)和28名健康自愿者(对照组)通过MRI扩散张量成像扫描进行脑白质束示踪,测量示踪纤维数和示踪纤维密度,并应用配对t检验比较两组间差异；对MS组脱髓鞘斑块、正常表现脑白质和对照组感兴趣区的ADC值和FA值进行方差分析,使用线性回归模型计算MS组脑白质束示踪的定量结果与EDSS评分的相关性. 结果在MS组脑白质束示踪三维仿真图像中可直接观察到脑白质束的受损和减少.MS组的示踪纤维数(2220±100)和示踪纤维密度(0.75±0.04)明显低予对照组(2750±70、0.93±0.02),差异有统计学意义(P＜0.05).MS组脱髓鞘斑块、正常表现脑白质和对照组感兴趣区的ADC值依次下降,分别为(1.23 ±0.13)× 10-3 mm2/s、(0.76±0.09)× 10-3 mm2/s、(0.63 ±0.10)×10-3 mm2/s; FA值依次升高,分别为0.24±0.04、0.42±0.07、0.48±0.06,差异均有统计学意义(P＜0.05).MS组示踪纤维数和示踪纤维密度都与EDSS评分呈负相关关系(r=-0.782,P=0.000;r=-0.771,P=0.000). 结论通过MRI扩散张量成像扫描进行脑白质束示踪可以发现MS患者脑白质束的受损情况,其较常规MRI能提供更多的空间信息.
목적 연구다발성경화(MS)환자뇌백질속시종적삼유방진영상표현,평개기정량결과여잔질상태확전평분(EDSS)적상관성. 방법 대28례MS환자(MS조)화28명건강자원자(대조조)통과MRI확산장량성상소묘진행뇌백질속시종,측량시종섬유수화시종섬유밀도,병응용배대t검험비교량조간차이；대MS조탈수초반괴、정상표현뇌백질화대조조감흥취구적ADC치화FA치진행방차분석,사용선성회귀모형계산MS조뇌백질속시종적정량결과여EDSS평분적상관성. 결과 재MS조뇌백질속시종삼유방진도상중가직접관찰도뇌백질속적수손화감소.MS조적시종섬유수(2220±100)화시종섬유밀도(0.75±0.04)명현저여대조조(2750±70、0.93±0.02),차이유통계학의의(P＜0.05).MS조탈수초반괴、정상표현뇌백질화대조조감흥취구적ADC치의차하강,분별위(1.23 ±0.13)× 10-3 mm2/s、(0.76±0.09)× 10-3 mm2/s、(0.63 ±0.10)×10-3 mm2/s; FA치의차승고,분별위0.24±0.04、0.42±0.07、0.48±0.06,차이균유통계학의의(P＜0.05).MS조시종섬유수화시종섬유밀도도여EDSS평분정부상관관계(r=-0.782,P=0.000;r=-0.771,P=0.000). 결론 통과MRI확산장량성상소묘진행뇌백질속시종가이발현MS환자뇌백질속적수손정황,기교상규MRI능제공경다적공간신식.
Objective To study the quantitative fiber tractography variations and 3D simulation patterns in patients with multiple sclerosis (MS),and assess the correlation between quantitative fiber tractography and scores of expanded disability status scale (EDSS).Methods MR diffusion tensor imaging was applied in 28 MS patients and 28 age-matched healthy volunteers.Then,quantitative tractography was generated in all subjects; and mean numbers of tracked lines and fiber density were measured.Paired-samples t tests were used to compare tracked lines and fiber density in MS patients with those in controls.Analysis of variance of ADC value and FA value was applied to MS patients having demyelinating plaque and normal appearing white matter,and controls.Linear regression model was used to determine the relationship between quantitative fiber tractography and scores of EDSS in MS patients.Results Tractography's tracked lines (2220±100) and fiber density (0.75±0.04) in MS patients were less than those in controls (2750±70) and (0.93±0.02,P＜0.05).In MS patients having plaque and normal appearing white matter,and controls,the ADC values of ROI were (1.23±0.13)× 10-3 mm2/s,(0.76±0.09)×10-3 mm2/s and (0.63±0.10)×10-3 mm2/s,respectively,with a gradual declined trend; and the FA values were 0.24±0.04,0.42±0.07 and 0.48±0.06,respectively,with a gradual increased trend; significant differences were noted between each 2 groups (P＜0.05).Both tracked lines and fiber density were found negative correlations with scores of EDSS in MS patients (P＜0.05).Conclusion Damages of white matter tracts in MS patients can be detected by diffusion tensor fiber tractography,and it provide more space information than conventional MRI.