中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2009年
10期
1017-1020
,共4页
王岩%马林%李德军%郭行高
王巖%馬林%李德軍%郭行高
왕암%마림%리덕군%곽행고
肌萎缩侧索硬化%磁共振成像,弥散%脊髓
肌萎縮側索硬化%磁共振成像,瀰散%脊髓
기위축측색경화%자공진성상,미산%척수
Amyotrophic lateral sclerosis%Diffusion magnetic resonance imaging%Spinal cord
目的 了解常规MR检查阴性的肌萎缩侧索硬化症(ALS)患者颈髓DTI的各项参数值的变化情况.方法 选取临床诊断为ALS患者(ALS组)16例及16名年龄、性别匹配的健康志愿者(正常组)行颈髓常规MRI及横断面DTI.DTI图像经工作站(AW4.2)后处理,获得ADC图、部分各向异性(FA)图和相对各向异性(RA)图.在C3椎体水平层面分别在颈髓前索区、后索区及双侧皮质脊髓侧束区4个区域内选取面积约5 mm ×5 mm的ROI,测定其ADC值、FA值和RA值.使用独立样本t检验对两组间各项参数值进行比较,使用Pearson相关分析分别对ALS患者异常参数值与ALS患者病程、Norris评分及功能质量相关评分(ALSFRS)进行相关性分析.结果 ALS组左、右侧皮质脊髓侧束的FA、RA值较正常组减低.其中ALs组左侧皮质脊髓侧束的FA、RA值为0.762±0.089、0.762±0.107,正常组为0.863±0.098、0.890±0.105;ALS组右侧皮质脊髓侧束的FA、RA值为0.751±0.065、0.772±0.082,正常组为0.843±0.118、0.863±0.134,差异均具有统计学意义(t值分别为2.575、4.195、2.246、2.218,P值均<0.05).ALS组左、右侧皮质脊髓侧束的ADC值分别为(0.744±0.162)、(0.767±0.141)×10~(-3)mm~2/s,正常组为(0.640±0.149)、(0.643±0.168)×10~(-3)mm~2/s,两组间差异无统计学意义(t值分别为-1.319、-1.087,P值均>0.05).ALS组前索FA、RA及ADC值分别为0.637±0.113、0.622±0.138、(0.950±0.354)× 10~(-3)mm~2/s,正常组分别为0.670±0.117、0.656±0.136、(0.865±0.238)×10~(-3)mm~2/s,两组间差异无统计学意义(t值分别为0.854、-0.704、-1.155,P值均>0.05).ALS组后索FA、RA及ADC值分别为0.886±0.073、0.920±0.100、(0.613±0.137)×10~(-3)mm~2/s,正常组分别为0.906±0.078、0.914±0.135、(0.636±0.224)×10~(-3)mm~2/s,两组间差异也无统计学意义(t值分别为1.655、-0.148,-1.360,P值均>0.05).ALS患者左、右侧皮质脊髓侧束FA、RA值与ALS病程、临床Norris评分及ALSFRS之间均无相关性(P值均>0.05).结论 SE-EPI序列DTI用于ALS患者颈髓的检测,其扫描方法简单且比较敏感,可以反映常规MRI上未能显示的病理学改变.
目的 瞭解常規MR檢查陰性的肌萎縮側索硬化癥(ALS)患者頸髓DTI的各項參數值的變化情況.方法 選取臨床診斷為ALS患者(ALS組)16例及16名年齡、性彆匹配的健康誌願者(正常組)行頸髓常規MRI及橫斷麵DTI.DTI圖像經工作站(AW4.2)後處理,穫得ADC圖、部分各嚮異性(FA)圖和相對各嚮異性(RA)圖.在C3椎體水平層麵分彆在頸髓前索區、後索區及雙側皮質脊髓側束區4箇區域內選取麵積約5 mm ×5 mm的ROI,測定其ADC值、FA值和RA值.使用獨立樣本t檢驗對兩組間各項參數值進行比較,使用Pearson相關分析分彆對ALS患者異常參數值與ALS患者病程、Norris評分及功能質量相關評分(ALSFRS)進行相關性分析.結果 ALS組左、右側皮質脊髓側束的FA、RA值較正常組減低.其中ALs組左側皮質脊髓側束的FA、RA值為0.762±0.089、0.762±0.107,正常組為0.863±0.098、0.890±0.105;ALS組右側皮質脊髓側束的FA、RA值為0.751±0.065、0.772±0.082,正常組為0.843±0.118、0.863±0.134,差異均具有統計學意義(t值分彆為2.575、4.195、2.246、2.218,P值均<0.05).ALS組左、右側皮質脊髓側束的ADC值分彆為(0.744±0.162)、(0.767±0.141)×10~(-3)mm~2/s,正常組為(0.640±0.149)、(0.643±0.168)×10~(-3)mm~2/s,兩組間差異無統計學意義(t值分彆為-1.319、-1.087,P值均>0.05).ALS組前索FA、RA及ADC值分彆為0.637±0.113、0.622±0.138、(0.950±0.354)× 10~(-3)mm~2/s,正常組分彆為0.670±0.117、0.656±0.136、(0.865±0.238)×10~(-3)mm~2/s,兩組間差異無統計學意義(t值分彆為0.854、-0.704、-1.155,P值均>0.05).ALS組後索FA、RA及ADC值分彆為0.886±0.073、0.920±0.100、(0.613±0.137)×10~(-3)mm~2/s,正常組分彆為0.906±0.078、0.914±0.135、(0.636±0.224)×10~(-3)mm~2/s,兩組間差異也無統計學意義(t值分彆為1.655、-0.148,-1.360,P值均>0.05).ALS患者左、右側皮質脊髓側束FA、RA值與ALS病程、臨床Norris評分及ALSFRS之間均無相關性(P值均>0.05).結論 SE-EPI序列DTI用于ALS患者頸髓的檢測,其掃描方法簡單且比較敏感,可以反映常規MRI上未能顯示的病理學改變.
목적 료해상규MR검사음성적기위축측색경화증(ALS)환자경수DTI적각항삼수치적변화정황.방법 선취림상진단위ALS환자(ALS조)16례급16명년령、성별필배적건강지원자(정상조)행경수상규MRI급횡단면DTI.DTI도상경공작참(AW4.2)후처리,획득ADC도、부분각향이성(FA)도화상대각향이성(RA)도.재C3추체수평층면분별재경수전색구、후색구급쌍측피질척수측속구4개구역내선취면적약5 mm ×5 mm적ROI,측정기ADC치、FA치화RA치.사용독립양본t검험대량조간각항삼수치진행비교,사용Pearson상관분석분별대ALS환자이상삼수치여ALS환자병정、Norris평분급공능질량상관평분(ALSFRS)진행상관성분석.결과 ALS조좌、우측피질척수측속적FA、RA치교정상조감저.기중ALs조좌측피질척수측속적FA、RA치위0.762±0.089、0.762±0.107,정상조위0.863±0.098、0.890±0.105;ALS조우측피질척수측속적FA、RA치위0.751±0.065、0.772±0.082,정상조위0.843±0.118、0.863±0.134,차이균구유통계학의의(t치분별위2.575、4.195、2.246、2.218,P치균<0.05).ALS조좌、우측피질척수측속적ADC치분별위(0.744±0.162)、(0.767±0.141)×10~(-3)mm~2/s,정상조위(0.640±0.149)、(0.643±0.168)×10~(-3)mm~2/s,량조간차이무통계학의의(t치분별위-1.319、-1.087,P치균>0.05).ALS조전색FA、RA급ADC치분별위0.637±0.113、0.622±0.138、(0.950±0.354)× 10~(-3)mm~2/s,정상조분별위0.670±0.117、0.656±0.136、(0.865±0.238)×10~(-3)mm~2/s,량조간차이무통계학의의(t치분별위0.854、-0.704、-1.155,P치균>0.05).ALS조후색FA、RA급ADC치분별위0.886±0.073、0.920±0.100、(0.613±0.137)×10~(-3)mm~2/s,정상조분별위0.906±0.078、0.914±0.135、(0.636±0.224)×10~(-3)mm~2/s,량조간차이야무통계학의의(t치분별위1.655、-0.148,-1.360,P치균>0.05).ALS환자좌、우측피질척수측속FA、RA치여ALS병정、림상Norris평분급ALSFRS지간균무상관성(P치균>0.05).결론 SE-EPI서렬DTI용우ALS환자경수적검측,기소묘방법간단차비교민감,가이반영상규MRI상미능현시적병이학개변.
Objective To determine whether normal-appearing cervical spinal cord in patients with amyotrophic lateral sclerosis (ALS) has abnormal changes based on the quantitative measurement in healthy volunteers. Methods Conventional MRI and axial DTI were obtained in 16 patients with ALS (ALS group) and 16 age-matched control subjects (normal group) . ADC, fractional anisotropy (FA) and relative anisotropy(RA)imagcs were obtained on workstation (AW4. 2). ROIs (5 mm × 5 mm) were placed in anterior funicalus, posterior funiculus, and bilateral lateral corticospinal tracts (LCTs), respectively, at the same slice (C3). Independent-sample t test was used for comparison of parameters between the two groups. Correlations between DTI parameters of ALS and ALS course, Norris score, and ALSFRS were carried out separately by Pearson correlation analysis. Results FA and RA values of bilateral LCTs were decreased significantly. FA/RA values of left LCT were 0.762±0.089 and 0.762±0.107 in ALS group, while they were 0.863±0.098 and 0.890±0.105 in control group, respectively. FA/RA values of right LCT were 0.751±0.065 and 0.772±0.082 in ALS group, and they were 0.843±0.118 and 0.863±0.134 in control group, respectively, they were decreased significantly (t = 2.575、4.195、2.246、2.218, P < 0.05). There were no significant differences (t = - 1.319, - 1.087, P > 0.05) between ADC values of left and right CSTs in ALS group [(0.744±0.162) × 10~(-3), (0.767±0.141) × 10-~(3) mm~2/s] and control group [(0.640±0.149) ×10~(-3), (0.643±0.168) ×10~(-3) mm~2/s)]. FA, RA and ADC values of ALS patients in anterior funiculus were 0.637±0.113, 0.622±0.138, (0.950±0.354)×10~(-3) mm~2/s, in control group they were 0.670±0.117, 0.656±0.136, (0.865±0.238) × 10~(-3) mm~2/s, there were no significant differences (t = 0.854, - 0.704, - 1.155,P > 0.05). FA, RA and ADC values of ALS patients in posterior funieulus were 0.886±0.073, 0.920±0.100, (0.613±0.137)×10~(-3) mm~2/s, in control group they were 0.906±0.078, 0.914±0.135, (0.636±0.224) × 10~(-3) mm~2/s, there were no significant differences (t = 1.655, - 0.148, - 1.360; P > 0.05). No significant correlation existed between FA and RA values and disease course, Norris and ALSFRS score (P > 0.05), in left and right LCTs. Conclusion DTI with SE-EPI technique is simple and sensitive to detect the pathological changes of the cervical spinal cord in ALS patients. DTI can reveal the abnormalities which are "normal appearing" on conventional T_2WI.
