复发缓解型多发性硬化联络纤维的DTI多参数定量分析

发布时间：2018-01-31 12:36

本文关键词： 复发缓解型多发性硬化扩散张量成像联络纤维临床功能　出处：《临床放射学杂志》2017年11期 　论文类型：期刊论文

【摘要】：目的应用扩散张量成像(DTI)检测复发缓解型多发性硬化(RRMS)联络纤维的微观结构改变,探讨DTI各种定量参数与临床功能之间的相关性。方法搜集RRMS患者33例以及年龄和性别相匹配的健康自愿者33名(对照组),均行MRI扫描,获取DTI图像,基于白质分区图谱对其进行测量分析,比较组间联络纤维主要纤维束的部分各向异性(FA)、平均扩散率(MD)、径向扩散率(RD)、轴向扩散率(AD)差异,并对RRMS患者各DTI参数与扩展残疾量表(EDSS)得分之间的相关性进行分析。结果 RRMS组较对照组在双侧扣带束、下额枕束、上额枕束、下纵束、上纵束、钩束的FA值下降,差异均具有显著性;RRMS组较对照组在双侧扣带束、下额枕束、上额枕束、下纵束、上纵束、钩束的MD值升高,差异均具有显著性;RRMS组较对照组在双侧上额枕束、双侧下纵束、双侧上纵束、右侧钩束RD值升高,差异均具有显著性;RRMS组较对照组在双侧扣带束、左侧钩束的RD值无显著差异;RRMS组较对照组双侧扣带束、下额枕束、上额枕束、下纵束、上纵束、钩束的AD值升高,差异均具有显著性。RRMS患者的双侧扣带束、下额枕束、上额枕束、下纵束、上纵束、钩束的FA值、MD值、RD值、AD值与EDSS评分之间均无相关性。结论 RRMS患者联络纤维各主要纤维束存在髓鞘完整性破坏及轴索的损害等微观结构改变;各种参数值的改变与临床功能无相关性。
[Abstract]:Objective to detect the microstructural changes of recurrent multiple sclerosis (RRMS) fibers by diffusion Zhang Liang imaging (DTI). To investigate the correlation between the quantitative parameters of DTI and clinical function. Methods 33 patients with RRMS and 33 healthy volunteers matched with age and sex were examined by MRI. The DTI images were obtained and measured and analyzed based on the white matter map. The partial anisotropy of the main fiber bundles was compared, and the average diffusivity and radial diffusivity were compared. Axial diffusivity (AD). The correlation between the DTI parameters of RRMS patients and the scores of extended disability scale (EDSS) was analyzed. Results compared with the control group, the bilateral cingulate band bundle, the inferior frontal occipital bundle and the superior frontal occipital bundle were found in the RRMS group. The FA values of the lower longitudinal bundle, the upper longitudinal bundle and the hook bundle decreased, and the differences were significant. Compared with the control group, the MD values of the bilateral cingulate band bundle, the inferior frontal occipital bundle, the superior frontal occipital bundle, the lower longitudinal bundle, the superior longitudinal bundle and the hook bundle in the RRMS group were significantly higher than those in the control group. The Rd values of bilateral superior frontal occipital bundle, bilateral inferior longitudinal bundle, bilateral superior longitudinal bundle and right hook bundle in RRMS group were significantly higher than those in control group. The Rd value of the left hook bundle in RRMS group was not significantly different from that in the control group. The AD values of bilateral cingulate band bundle, inferior frontal occipital bundle, superior frontal occipital bundle, inferior longitudinal bundle, superior longitudinal bundle and hook bundle in RRMS group were significantly higher than those in the control group. The FA value of upper frontal occipital bundle, lower longitudinal bundle, superior longitudinal bundle and hook bundle were measured by MD value and Rd value. There was no correlation between AD value and EDSS score. Conclusion the damage of myelin integrity and axonal damage was found in the main fiber bundles in patients with RRMS. There was no correlation between the change of parameters and clinical function.
【作者单位】：贵州医科大学附属医院影像科;贵州医科大学附属医院神经科;贵州医科大学第二附属医院神经科;
【分类号】：R445.2;R744.51
【正文快照】： 多发性硬化(multiple sclerosis,MS)是以脱髓鞘、轴索损伤、炎症、神经胶质增生及神经元丢失为特征的中枢神经系统的神经退化疾病[1,2]。大约有40%~70%的MS患者有功能障碍[3],通常为感觉障碍、视觉障碍及运动障碍。常规MRI检测出的可见白质病灶并不能彻底阐明其复杂多样的临床

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