CAJ | 학술논문

目的：评价3．0 T磁共振扩散张量成像( DTI)对鉴别脑白质疏松症( LA)与多发性硬化( MS)急性期病灶的诊断价值。方法选取2010年1月至2011年10月在河北医科大学第二医院及河北省人民医院神经内科就诊的已确诊为LA的患者68例以及确诊为MS的患者36例作为研究对象,应用3．0 T磁共振对68例LA患者及36例MS患者行常规MRI及DTI检查,重建出表观扩散系数( ADC)部分及各向异性( FA)图,测量LA病灶及MS急性期病灶的FA值及ADC值并进行比较。结果单纯LA及急性期MS病灶常规MRI均表现为长T1长T2信号,急性期MS患者中脑室周围高信号(PVH)分型为1型的患者比例显著高于单纯LA组PVH1型的比例(χ2=18．457,P<0．01)。表现为PVH 1型的LA患者,其侧脑室前角周围、侧脑室后角的ADC值与PVH 1型急性期MS患者在上述区域的ADC值比较差异无统计学意义(t=1．447,1．862,P>0．05),而位于放射冠区域的ADC值比较差异有统计学意义(t=2．885,P<0．01),这3个区域的FA值比较差异均有统计学意义(t=3．425,4．531,7．226,P<0．01)。结论 DTI技术能够更为准确地量化指标,有助于在不进行增强扫描的情况下较为准确的分辨LA与急性期MS病灶,为MS的早期诊断、早期治疗提供参考。
목적：평개3．0 T자공진확산장량성상( DTI)대감별뇌백질소송증( LA)여다발성경화( MS)급성기병조적진단개치。방법선취2010년1월지2011년10월재하북의과대학제이의원급하북성인민의원신경내과취진적이학진위LA적환자68례이급학진위MS적환자36례작위연구대상,응용3．0 T자공진대68례LA환자급36례MS환자행상규MRI급DTI검사,중건출표관확산계수( ADC)부분급각향이성( FA)도,측량LA병조급MS급성기병조적FA치급ADC치병진행비교。결과단순LA급급성기MS병조상규MRI균표현위장T1장T2신호,급성기MS환자중뇌실주위고신호(PVH)분형위1형적환자비례현저고우단순LA조PVH1형적비례(χ2=18．457,P<0．01)。표현위PVH 1형적LA환자,기측뇌실전각주위、측뇌실후각적ADC치여PVH 1형급성기MS환자재상술구역적ADC치비교차이무통계학의의(t=1．447,1．862,P>0．05),이위우방사관구역적ADC치비교차이유통계학의의(t=2．885,P<0．01),저3개구역적FA치비교차이균유통계학의의(t=3．425,4．531,7．226,P<0．01)。결론 DTI기술능구경위준학지양화지표,유조우재불진행증강소묘적정황하교위준학적분변LA여급성기MS병조,위MS적조기진단、조기치료제공삼고。
Objectives To evaluate the diagnostic value of 3. 0 T MR diffusion tensor imaging(DTI) in distinguish acute lesions of multiple sclerosis( MS) from simple leukoaraiosis ( LA) . Methods From Jan. 2010 to Oct. 2011,in the Second Hospital of Hebei Medical University and Hebei General Hospital,68 patients diagnosed as LA and 36 cases diagnosed as MS were studied as the objects. All the patients were examined by 3. 0 T conventional MRI and DTI. Reconstruction of the apparent diffusion coefficient ( ADC) map and the fraction anisotropy ( FA) maps was done to measure and compare FA values and ADC values of simple LA lesions and acute lesions of MS. Results Both LA and MS showed low signal intensity on T1-weighted images and high intensity on T2-weighted images. The number of patients with MS in acute stage of PVH typing for type 1 was significantly higher than that in LA group (χ2 =18. 4571,P<0. 01). Comparing the value of ADC between the patients in acute stage and PVH type 1 MS and PVH type 1 LA,it was found that, the ADC value of the regions around the anterior horn of lateral ventricle and posterior horn of lateral ventricle were shown no statistically significant difference (t=1. 447,1. 862,P>0. 05),but in the corona regions,the ADC value had statistically significant difference (t=2. 885,P<0. 01). The FA values of the 3 regions had statistically significant difference(t=3. 425,4. 531,7. 226,P<0. 01). Conclusion DTI technology,which can provide more accurate quantitative indicators,can distinguish acute lesions of MS from simple LA lesions without enhancement scanning,providing reference for the early diagnosis and treatment of MS.