3. 0T 磁共振扩散张量及其纤维束成像在脑多发性硬化诊断中的应用价值

目的研究多发性硬化的脑内病灶在磁共振扩散张量成像（DTI）及扩散张量白质纤维束成像（DTr）中的主特征及其量化分析。方法应用3．0T磁共振对临床确诊的10例多发性硬化（MS）患者及10名健康志愿者行常规头颅MRI和DT[扫描，选取MS病灶区域，即丘脑、内囊、胼胝体、半卯圆中心及顶叶典型病灶45处（丘脑5、内囊8、胼胝体10、半卵圆中心12、顶叶10）；病灶旁正常脑白质部位（NAWM）以及健康志愿者与MS病灶相同部位作为感兴趣区，测量扩散张量参数值一FA值、ADC值及MD值，并对以上3组的结果进行统计学分析。结果多发性硬化病灶FA平均值0．29±0．10，ADC平均值（1．03±0．12）×10-9mm2·s-1，MD平均值（1．01±0．12×10-9mm2·s-1；NAWMFA平均值0．35±0．19，ADC平均值（0．85±0．01）×10-9mm2·s-1，MD平均值（0．89±0．13）×10-9mm2·s-1；健康自愿者FA平均值0．50±O．05，ADC平均值（0．72±O．04）×10-9mm2·s-1，MD平均值（0．73±0．04）×10-9mm2·s-1。MS组、NAWM组、健康志愿者组3组在丘脑和内囊2个部位上的MD、FA、ADC值存在差异，但差异均无统计学意义（P〉0．05）。3组在胼胝体、半卵圆中心、顶叶上的MD、FA、ADC值，两两比较差异有统计学意义（P〈0．05）。结论DTI及DTF可以反映MS不同时期病灶的病理变化，为观测疾病演变和评价临床疗效等方面提供了有效的指标。

Value of diffusion tensor imaging and diffusion tensor tractography in diagnosis of multiple sclerosis in 3.0T magnetic resonance

Objective To observe the key feature and quantificat analysis with diffusion tensor imaging （DTI） and diffusion tensor tractography （DTT） of intracephalic multiple sclerosis. Methods 3.0T MR for clinical definite of 10 cases intracephalic multiple sclerosis patients and 10 healthy volunteers underwent routine MRI scans and DTI scans, then selected 45 ROIs of the typical lesion region （thalamus 5 ROIs, internal capsule 8 ROIs, corpus callosum 10 ROIs, semioval center 12 ROIs and the parietal lobe 10 ROIs）, NAWM and healthy volunteers in the same anatomic site as the region of interest to measure the diffusion tensor parameter values FA, ADC and MD values, the results of three groups were analyzed. Results The FA average value of Multiple sclerosis lesions was 0.29 ± 0. lO;the ADC average value was 1.03±0.12 ×10-9mm2·s-1, The MD average value was 1.01±0.12 ×10-9mm2·s-1 ;The FA average value of NAWM was 0.35 ± 0.19, the ADC average value was 0.85 ± 0.01 ×10-9mm2·s-1 and its MD average value was 0.89 ± 0.13 ×10-9mm2·s-1. The FA average value of healthy volunteers was 0.50 ± 0.05, the average value of ADC was 0.72 ± 0.04 ×10-9mm2·s-1 and its average value of MD was 0.73 V0.04 ×10-9mm2·s-1. The MD, FA and ADC values had differences in the thalamus and internal capsule of the group of multiple sclerosis lesions, the groups of NAWM and the group of healthy volunteers. But there were not significant difference（ P 〉 0.05 ）. There are differences in MD, FA and ADC values of corpus eallosum, semioval center and the parietal lobe. Then pairwised comparison, differences were statistically significant （ P 〈 0.05 ）. Conlusion DTI and DTI tech- nique can reflect pathological changes of various changes in MS as well as can be used to observe the variation of MS and evaluate clinical curative effect DTI and DTT provide effective index in MS.Objective To observe the key feature and quantificat analysis with diffusion tensor imaging （DTI） and diffusion tensor tractography （DTT） of intracephalic multiple sclerosis. Methods 3.0T MR for clinical definite of 10 cases intracephalic multiple sclerosis patients and 10 healthy volunteers underwent routine MRI scans and DTI scans, then selected 45 ROIs of the typical lesion region （thalamus 5 ROIs, internal capsule 8 ROIs, corpus callosum 10 ROIs, semioval center 12 ROIs and the parietal lobe 10 ROIs）, NAWM and healthy volunteers in the same anatomic site as the region of interest to measure the diffusion tensor parameter values FA, ADC and MD values, the results of three groups were analyzed. Results The FA average value of Multiple sclerosis lesions was 0.29 ± 0. lO;the ADC average value was 1.03±0.12 ×10-9mm2·s-1, The MD average value was 1.01±0.12 ×10-9mm2·s-1 ;The FA average value of NAWM was 0.35 ± 0.19, the ADC average value was 0.85 ± 0.01 ×10-9mm2·s-1 and its MD average value was 0.89 ± 0.13 ×10-9mm2·s-1. The FA average value of healthy volunteers was 0.50 ± 0.05, the average value of ADC was 0.72 ± 0.04 ×10-9mm2·s-1 and its average value of MD was 0.73 V0.04 ×10-9mm2·s-1. The MD, FA and ADC values had differences in the thalamus and internal capsule of the group of multiple sclerosis lesions, the groups of NAWM and the group of healthy volunteers. But there were not significant difference（ P 〉 0.05 ）. There are differences in MD, FA and ADC values of corpus eallosum, semioval center and the parietal lobe. Then pairwised comparison, differences were statistically significant （ P 〈 0.05 ）. Conlusion DTI and DTI tech- nique can reflect pathological changes of various changes in MS as well as can be used to observe the variation of MS and evaluate clinical curative effect DTI and DTT provide effective index in MS.