肌萎缩侧索硬化症的DTI及MRS研究:3T所见

目的应用扩散张量成像(DTI)和磁共振波谱成像(MRS)研究肌萎缩侧索硬化(ALS)上运动神经元受累情况。方法36例ALS患者和36名无神经系统异常的年龄性别匹配的正常人行头颅常规MRI、DTI和1HMRS。分别测量双侧大脑脚及内囊后肢3/4处各向异性分数(FA)值、NAA/Cr值和Cho/Cr值。结果ALS患者组较正常对照组FA值、NAA/Cr值明显降低,Cho/Cr值明显升高,有显著统计学差异。分别分析36例患者的DTI和MRS,其中FA值异常26例(占72.2%),MRS异常有32例(占88.9%),二者结合显示异常有34例(占94.4%)。结论DTI和MRS结合可以明显提高ALS上运动神经元受累的诊断敏感性。

Study of amyotrophic lateral sclerosis with DTI and MRS: findings at 3T

Objective To investigate upper motor neurons involvement in amyotrophic lateral sclerosis (ALS) by diffusion tensor imaging (DTI) and magnetic resonance spectroscopy (MRS). Methods Thirty-six patients with ALS and thirty-six age- and sex-matched controls without neurological disorders underwent conventional MRI, DTI and MRS examinations. Fractional anisotropy (FA) value, NAA/Cr ratio and Cho/Cr ratio were measured respectively in bilateral cerebral peduncles (CP) and the third quarter of posterior limb (PL) of the internal capsule (IC). Results Compared with controls, in ALS patients the FA and NAA/Cr were significantly decreased, and the Cho/Cr was significantly increased (P<0.05). Among 36 ALS patients, FA values were abnormal in 26 (72.2%), while MRS abnormal in 32 (88.9%). With a combination of FA and MRS, diagnostic sensitivity could reach 34 (94.4%). Conclusion A combination of DTI and MRS could markedly increase the diagnostic sensitivity in upper motor neuron involvement of ALS.