An investigation of diffusion imaging techniques in the evaluation of spinocerebellar ataxia and multisystem atrophy.
An investigation of diffusion imaging techniques in the evaluation of spinocerebellar ataxia and multisystem atrophy.
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DOI：
10.1016/j.jocn.2014.08.006
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发表时间：
2015-01
期刊：
影响因子：
--
通讯作者：
Opal P
中科院分区：
文献类型：
--
作者：
Rozenfeld MN;Nemeth AJ;Walker MT;Mohan P;Wang X;Parrish TB;Opal P
多系统萎缩和脊髓小脑共济失调是罕见的神经退行性共济失调，难以诊断，具有重要的预后和治疗意义。本研究的目的是评估各种方法的扩散成像和纤维束成像在区分这些疾病的有效性从控制科目。我们的第二个目的是确定弥散异常是否与临床疾病的严重程度相对应。对5例患者和7例年龄匹配的对照者进行了弥散成像和纤维束成像。分数各向异性，广义分数各向异性，和表观扩散系数值和皮质脊髓束体积内测量各种扩散和概率纤维束成像模型，包括标准扩散张量和Q球纤维束成像。与对照组相比，患者小脑中脚和中央脑桥的标准弥散各向异性分数和表观弥散系数值发生了显著变化。与对照组相比，当皮质脊髓束在头尾方向上绘制时（双侧使用Q球成像，仅在右侧使用扩散张量成像），患者基于纤维束成像的分数各向异性和广义分数各向异性值显著较低。当在尾颅方向使用Q球成像时，患者的右侧皮质脊髓束体积显著小于对照组。弥散改变与临床表现无相关性。总之，各种基于扩散的技术可以有效地区分共济失调患者与对照受试者，虽然扩散算法和束生长技术和方向的选择是不平凡的。
Multisystem system atrophy and spinocerebellar ataxia are rare neurodegenerative ataxias that can be difficult to diagnose, with important prognostic and treatment implications. The purpose of this study is to evaluate various methods of diffusion imaging and tractography in their effectiveness at differentiating these diseases from control subjects. Our secondary aim is determining whether diffusion abnormalities correspond with clinical disease severity. Diffusion imaging and tractography were performed on five patients and seven age-matched controls. Fractional anisotropy, generalized fractional anisotropy, and apparent diffusion coefficient values and corticospinal tract volumes were measured within various diffusion and probabilistic tractography models, including standard diffusion tensor and Q-ball tractography. Standard diffusion based fractional anisotropy and apparent diffusion coefficient values were significantly altered in patients versus controls in the middle cerebellar peduncles and central pons. Tractography based fractional anisotropy and generalized fractional anisotropy values were significantly lower in patients versus controls when corticospinal tracts were drawn in a craniocaudal direction (bilaterally using Q-ball imaging, only on the right using diffusion tensor imaging). The right corticospinal tract volume was significantly smaller in patients versus controls when created using Q-ball imaging in a caudocranial direction. There was no correlation between diffusion alteration and clinical symptomatology. In conclusion, various diffusion-based techniques can be effective in differentiating ataxic patients from control subjects, although the selection of diffusion algorithm and tract growth technique and direction is non-trivial.
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