复发-缓解型多发性硬化边缘系统白质纤维束定量DTI改变

目的 探讨复发-缓解型多发性硬化(relapsing remitting multiple sclerosis,RRMS)患者边缘系统白质纤维束定量弥散张量的改变.方法 RRMS患者24例,年龄和性别相匹配的健康志愿者24例为对照进行MRI扫描,获取常规MRI图像和弥散张量成像(DTI)图像,经GE工作站处理后进行测量分析,比较2组边缘系统主要纤维束(扣带束、穹窿束和终纹束)不同部分各向异性指数(FA)值和平均弥散系数(MD)值的变化.结果 在考虑年龄和性别因素的影响后.RRMS组患者穹窿柬(F=15.605,P=0.000135)、右侧穹窿/终纹束(F=15.772,P=0.000127)、左侧穹窿/终纹束(F=8.53,P=0.004)的FA值较健康对照组明显降低; RRMS组患者穹窿束(F=13.28,P=0.0004)、右侧终纹柬(F=10.943,P= 0.002)、右侧穹窿/终纹束(F= 7.326,P=0.008)的MD值较健康对照组明显增高;RRMS组患者左/右侧的前、后扣带束、右侧终纹束(F= 0.986, P=0.326)、左侧终纹束的FA和对照组比较无明显差异,RRMS组患者左/右侧的前、后扣带束、左侧终纹束、左侧穹窿/终纹束的MD值较健康对照比较差异均无统计学意义.结论 DTI可作为反映RRMS边缘系统纤维束病理性改变的较敏感的检测方法.

Quantitative Diffusion Tensor Imaging of RRMS Changes in the Limbic System

Objective To study the changes of quantitative diffusion tensor imaging (DTI) values of limbic system fiber bundle in patients with relapsing remitting multiple sclerosis (RRMS). Methods 24 patients with RRMS and 24 healthy persons as control matched in the sex and age each other underwent conventional MR imaging and DTI,than fractional anisotropy (FA) / mean diffu-sivity (MD) of the limbic system fiber bundle (cingulum, fornix and stria terminalis fiber) were measured and the differences between two groups were analyzed. Results In comparison with controls, the RRMS patients showed diminished FA values in fornix bundle (F=15.605, P=0. 000135), right fornix/stria terminalis bundle (F= 15. 772, F=0. 000127) and left fornix/stria terminalis bundle(F=8. 53, P=0. 004); MD values increased in fornix bundle (F=13. 28, P=0. 0004), right fornix/stria terminalis bundle (F=7. 326, P=0. 008) and right stria terminalis bundle (F=10. 943, P=0. 002). FA and MD values in other regions of limbic system fiber bundle did not show any significant differences between two groups. Conclusion The quantitative DTI can sensitively determine the limbic system neural fiber bundle micro-pathological changes in RRMS patients.