复发-缓解型多发性硬化患者及复发型视神经脊髓炎患者双侧视放射的扩散张量成像研究

目的运用扩散张量成像(DTI)技术探讨复发-缓解型多发性硬化(RRMS)和复发型视神经脊髓炎(RNMO)患者看似正常视放射区DTI指标是否存在差异。材料与方法 RRMS患者、RNMO患者及年龄与性别相匹配的健康志愿者各20例行DTI检查,分别测量双侧视放射的FA值及MD值,并采用扩展残疾状态量表(EDSS)对两组患者进行评分。应用SPSS 17.0配对t检验、单因素方差分析及Dunnett-t检验分别分析患者组及健康对照组组内及组间两侧视放射的FA值及MD值,以及用Spearman软件分析DTI定量值与EDSS评分的相关性。结果 (1)健康对照组、RRMS及RNMO患者组组内双侧视放射FA值(t=0.41,P=0.68;t=0.10,P=0.92;t=0.63,P=0.54)及MD值(t=0.72,P=0.48;t=0.20,P=0.84;t=0.20,P=0.84)均没有明显差异(P0.05);RRMS及RNMO患者组左右两侧视放射FA值(P=0.00;P=0.00)均比健康对照组显著下降,MD值(P=0.00;P=0.00)均比健康对照组显著升高(P0.05);RNMO组双侧视放射FA值比RRMS组下降(P=0.02),而MD值(P=0.50)无明显差别;(2)RRMS组及RNMO组双侧视放射FA值(r=-0.19,P=0.42;r=0.20,P=0.41)及MD值(r=0.11,P=0.64;r=-0.33,P=0.15)与EDSS评分均没有明显的相关性(P0.05)。结论 RRMS及RNMO患者看似正常的视放射区均有受累,但二者视放射受累的程度不一致,FA值对鉴别MS及NMO具有潜在的应用价值,并可作为监测MS及NMO临床进展的重要生物学指标。

The study of DTI in bilateral optic radiation in relapsing-remitting multiple sclerosis and relapsing neuromyelitis optica

Objective: To investigate whether there are differences in diffusion tensor imaging (DTI) indexes between relapsing-remitting multiple sclerosis (RRMS) and relapsing neuromyelitis optica (RNMO) in the apparent normal optic radiation by DTI. Materials and Methods: Twenty cases RRMS and RNMO patients and 20 cases age- and sex- matched healthy volunteers received DTI. Fractional anisotropy (FA) value and mean diffusivity (MD) value were acquired on bilateral optic radiation individually, and all RRMS and RNMO patients were evaluated by the expanded disability status scale (EDSS). We compared FA and MD value of bilateral optic radiation in each group usingt test. We compared FA and MD value of bilateral optic radiation between each patient group and normal control group using one-way analysis of variance (one-way ANOVA) andDunnett-t test. To evaluate the association between DTI value and EDSS score we usedSpearman. All statistical analyses were conducted using SPSS 17.0.Results:(1) In each group, The bilateral optic radiation FA value (t=0.41, P=0.68. t=0.10,P=0.92.t=0.63,P=0.54) and MD value (t=0.72,P=0.48.t=0.20,P=0.84.t=0.20, P=0.84) were not significantly different (P>0.05), respectively. FA value (P=0.00.P=0.00) of bilateral optic radiation in patient group was signiifcantly lower than normal control group, while MD value (P=0.00, P=0.00) was signiifcantly higher than normal control group (P<0.05). FA value (P=0.02) in RNMO patients was decreased than that of the RRMS patients, but the MD value (P=0.50) was not signiifcantly different. (2) There were not correlations between both FA (r=-0.19,P=0.42.r=0.20,P=0.41) and MD (r=0.11,P=0.64.r=-0.33,P=0.15) values of bilateral optic radiation and EDSS scores (P>0.05) in RRMS and RNMO.Conclusions:The appearing-normal optic radiation of both RRMS and RNMO patients was involved, but the involvement degree was not consistent in the two groups. FA value has potential applications to identify MS and NMO, as an important biological indicator for monitoring clinical course progress.