磁共振成像对实验性自身免疫性脑脊髓炎动物模型及多发性硬化患者中央前回灰质铁含量的研究

发布时间：2018-03-03 14:24

本文选题：实验性自身性免疫性脑脊髓炎　切入点：铁　出处：《重庆医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：第一部分磁共振成像观察实验性自身免疫性脑脊髓炎动物模型脑内铁沉积的研究目的采用3-D增强型T*2加权血管成像(ESWAN)序列观察实验性自身免疫性脑脊髓炎（EAE）动物模型脑内病灶铁沉积的情况，为多发性硬化(MS)的铁异常沉积的机制研究提供依据。方法制备EAE大鼠模型15只和对照组15只；在EAE模型发病的初发期（出现症状）及高峰期，，对EAE组和对照组分别行常规T1WI、T2WI和ESWAN扫描，接着在其尾静脉内注入Gd-DTPA，5分钟后行增强T1WI，扫描完毕后立即处死EAE大鼠和对照组大鼠，取其脑组织，行HE染色和Prussian blue染色。结果 EAE模型组第13天时出现症状为初发期、第17天达到症状高峰期；MRI检查：增强T1WI可见病灶明显强化；ESWAN相位图显示相应病灶区呈低信号；病理检查：HE染色可见病灶区血管周围的炎症细胞；Prussian blue染色病灶区血管周围巨噬细胞内未见明显的蓝染颗粒。结论本实验成功制备了急性EAE动物模型，采用Prussian blue染色没有发现大脑病灶区明显的铁沉积，可能主要与EAE动物模型病程较短及与感兴趣区选择部位有关，推测较长的病程可能更适合观察病灶内铁的沉积。第二部分MRI对复发-缓解型多发性硬化患者中央前回灰质铁沉积的研究第一节复发-缓解型多发性硬化患者中央前回灰质的铁沉积ESWAN定量研究目的利用3.0T MRI3-D增强型T*2加权血管成像(ESWAN)序列观察复发-缓解型多发性硬化(RRMS)患者中央前回灰质铁沉积及其与中央前回体积、临床参数的相关性。方法收集RRMS患者30例及性别、年龄相匹配的正常对照组30例，在相位图上测量中央前回灰质铁沉积，采用平均相位值（MPV）表示，分析两组中央前回灰质MPV值有无差异，并比较其与中央前回体积、病程及临床EDSS评分的相关性。结果 1) RRMS组和对照组中央前回MPV值分别为2033.13±14.39、2236.88±137.86；两组中央前回体积分别为2201.34±78.71（mm3）、2339.15±130.09（mm3）。 2) RRMS患者中央前回灰质MPV值和对照组相比有统计学差异(t=-8.05, P＜0.05)；中央前回体积与对照组相比有统计学差异(t=-4.96, P＜0.05)。 3) RRMS患者中央前回灰质MPV值与中央前回体积呈正相关(rs=0.364, P=0.048)，与病程呈负相关(rs=-0.369, P=0.045)，与EDSS评分无相关性(rs=-0.076, P＞0.05)，与复发次数呈负相关（rs=-0.367，P＜0.05)。结论 RRMS患者与对照组相比，中央前回灰质铁异常沉积增加，铁将来可能成为一种新的生物学指标。第二节MRI纵向观察复发-缓解型多发性硬化患者中央前回灰质铁沉积目的应用3.0T MRI3-D增强型T*2加权血管成像(ESWAN)序列纵向观察复发-缓解型多发性硬化(RRMS)患者中央前回灰质铁沉积的动态变化及其与中央前回体积、临床参数的相关性。方法纵向随访RRMS患者30例，进行两次常规MR、ESWAN及轴位3D T1WI扫描，间隔1年，测量中央前回灰质铁沉积，用平均相位值（MPV）表示，比较两次中央前回灰质MPV值和中央前回体积的变化，分析中央前回MPV值与中央前回体积、临床EDSS评分及病程的相关性。结果 1)30例RRMS患者两次测量中央前回灰质MPV值分别为（2033.131±14.39）和（2022.65±17.94），差异有统计学意义（P＜0.05）。两次测量中央前回体积分别为（2307.82±109.24）和（2216.82±118.70）mm3，差异无统计学意义（P＞0.05）。 2)前后两次测量中央前回灰质MPV值与中央前回体积均呈正相关(rs=0.764、0.592，P均＜0.05）；两次中央前回灰质MPV的差值与两次中央前回体积的差值呈正相关(rs=0.582， P＜0.05）。 3)两次EDSS评分的差值与两次中央前回体积的差值呈负相关(rs=-0.587， P＜0.05)，与两次中央前回灰质MPV的差值无相关性(P＞0.05)。 4)病程与第2次测量中央前回灰质MPV值呈负相关(rs=-0.399，P＜0.05)；复发次数与两次MPV的差值呈负相关（rs=-0.367，P＜0.05）。结论 RRMS患者中央前回灰质铁异常沉积随着病程进展而增加，且随着复发次数的增加而增加。
[Abstract]:The study of iron deposition in the brain of experimental autoimmune encephalomyelitis model in the first part of the magnetic resonance imaging
objective
3-D enhanced T*2 weighted angiography (ESWAN) sequence was used to observe the deposition of iron in the brain of experimental autoimmune encephalomyelitis (EAE) animal models, so as to provide evidence for the mechanism of iron deposition in multiple sclerosis (MS).
Method
Preparation of model 15 EAE rats and 15 rats in the control group; in the EAE model in the pathogenesis of early stage (symptoms) and the peak of the EAE group and the control group were treated with conventional T1WI, T2WI and ESWAN scan, then Gd-DTPA into the tail vein within 5 minutes after enhanced T1WI scan immediately after EAE rats were killed and the rats in the control group, the brain tissue, HE staining and Prussian blue staining.
Result
There is at the beginning of symptoms of EAE model group at thirteenth days, seventeenth days to reach the peak of symptoms: enhanced T1WI examination; MRI visible lesions showed obvious enhancement; ESWAN phase diagram shows the corresponding lesions showed low signal; pathological examination: peripheral vascular lesions visible inflammatory cells HE staining; Prussian staining of blue lesions were not found in perivascular macrophages the obvious blue dye particles.
conclusion
The animal model of acute EAE we successfully prepared using Prussian blue staining, no obvious lesion of brain iron deposition may be found, mainly with EAE animal model was shorter and the region of interest selection is related to the position, that may be more suitable for long duration observed in iron deposition lesions.
Second part MRI in the study of gray iron deposit in the central precentral gyrus of relapsed remission patients with multiple sclerosis
ESWAN quantitative study on iron deposition in precentral gray matter in patients with relapsed remission type multiple sclerosis
objective
Using 3.0T MRI3-D enhanced T*2 weighted angiography (ESWAN) sequence, we observed iron deposition in the central prefrontal gyrus and its correlation with central anterior volume and clinical parameters in patients with relapsing remitting multiple sclerosis (RRMS).
Method
We collected 30 patients with RRMS and gender, age matched normal control group of 30 cases, the measurement of anterior central gyrus gray iron deposition in the phase diagram, the average phase value (MPV), analysis of two groups of precentral gyrus gray matter MPV values had no difference, and compared with the precentral gyrus volume, disease history clinical and EDSS score.
Result
1) the MPV values in the central anterior gyrus of RRMS group and control group were 2033.13 + 14.392236.88 + 137.86, and two cases of central anterior gyrus volume were 2201.34 + 78.71 (mm3), 2339.15 + 130.09 (mm3), respectively.
2) the MPV value of gray matter in the central anterior gyrus of RRMS patients was statistically different from that in the control group (t=-8.05, P < 0.05). The volume of the anterior central gyrus was significantly different from that in the control group (t=-4.96, P < 0.05).
3) in RRMS patients, there was a positive correlation between MPV value in central prefrontal gyrus and the volume of anterior central gyrus (rs=0.364, P=0.048), which was negatively correlated with the course of disease (rs=-0.369, P=0.045), and had no correlation with EDSS score (rs=-0.076, P > 0.05), and negatively correlated with the number of relapses (rs=-0.367, P < 0.05).
conclusion
Compared with the control group, the abnormal deposition of gray iron in the central precentral gyrus increased, and iron may become a new biological indicator in the future.
Second section MRI longitudinal observation of central precentral gray iron deposition in recurrent remission patients with multiple sclerosis
objective
3.0T MRI3-D enhanced T*2 weighted angiography (ESWAN) sequence was used to observe the dynamic changes of iron deposition in the central prefrontal gyrus of patients with relapsing remitting multiple sclerosis (RRMS) and its correlation with central anterior volume and clinical parameters.
Method
30 cases of RRMS patients with longitudinal follow-up, two times of conventional MR, ESWAN and T1WI axial 3D scanning, 1 years apart, measuring the precentral gyrus gray iron deposition, with the average phase value (MPV), two times the precentral gyrus and precentral gyrus gray matter MPV volume changes, analysis of the precentral gyrus MPV the value and volume of the precentral gyrus, the correlation between clinical EDSS score and clinical course.
Result
1) in 30 cases of RRMS, the MPV value of gray matter in the anterior central gyrus was two times (2033.131 + 14.39) and (2022.65 + 17.94) in two times. The difference was statistically significant (P < 0.05). The volume of the central anterior gyrus measured by two times was 2307.82 (2307.82) 109.24 and (109.24 + two), respectively, and the difference was not statistically significant (P > rainfall).
2) before and after two measurements, the gray matter MPV value of the central anterior gyrus was positively correlated with the volume of the central anterior gyrus (rs=0.764,0.592, P < 0.05); the difference between the gray matter MPV of the two central anterior gyrus and the two central anterior volume was positively correlated (rs=0.582, P < 0.05).
3) there was a negative correlation between the difference between the two EDSS scores and the two central anterior loop volume (rs=-0.587, P < 0.05), and there was no correlation between the difference between the two time and the two precentral gyrus gray matter (P > 0.05).
4) the course of the disease was negatively correlated with the MPV value of the second times in the central anterior gyrus (rs=-0.399, P < 0.05), and the difference between the recurrence times and the two MPV was negatively correlated (rs=-0.367, P < 0.05).
conclusion
The abnormal deposition of gray iron in the precentral gyrus of RRMS patients increased with the progression of the disease, and increased with the increase of the number of relapses.

【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.2;R744.51

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