Increased iron accumulation occurs in the earliest stages of demyelinating disease: an ultra-high field susceptibility mapping study in Clinically Isolated Syndrome
Increased iron accumulation occurs in the earliest stages of demyelinating disease: an ultra-high field susceptibility mapping study in Clinically Isolated Syndrome
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DOI：
10.1177/1352458512465135
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发表时间：
2013-06-01
影响因子：
5.8
通讯作者：
Gowland, Penny A.
中科院分区：
文献类型：
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作者：
Al-Radaideh, Ali M.;Wharton, Samuel J.;Gowland, Penny A.
目的：为了确定，使用超高场磁共振成像（MRI），铁含量的变化是否发生在脱髓鞘疾病的最早阶段，通过量化的磁敏感性的深灰质结构的临床孤立综合征（CIS），这是提示多发性硬化症（MS）的患者，与年龄匹配的健康受试者相比。方法：我们比较了19例CIS患者和20例年龄匹配的健康对照。在7 T Philips Achieva系统上使用三维T2* 加权梯度回波采集对研究受试者进行扫描。相位数据首先高通滤波，使用偶极拟合方法，然后反转产生磁化率图。感兴趣区域（ROI）分析用于估计深部灰质结构的磁化率值（尾状核、壳核、苍白球、丘脑及其枕）。与对照组相比，CIS组尾状核的相对敏感性显著增加（p = < 0.01）、壳核（p < 0.01）、苍白球（p < 0.01）和枕（p < 0.05）。我们发现，无论是研究对照组还是CIS患者，在任何ROI中，易感性与年龄之间的关系都没有显著或一致的趋势（r（2）< 0.5; p > 0.05）。在CIS患者中，自临床事件和扩展残疾状态量表（EDSS）评分以来的时间与任何ROI中的铁水平均不相关（r（2）< 0.5; p > 0.05）;然而，T1病变负荷与尾状核的平均易感性之间存在中度相关性（r（2）= 0.3; p < 0.01）。CIS患者表现出增加的铁积累，如使用深灰质的易感性映射所测量的，这表明铁的变化确实发生在CIS疾病的早期阶段。
Objective: To determine, using ultra-high field magnetic resonance imaging (MRI), whether changes in iron content occur in the earliest phases of demyelinating disease, by quantifying the magnetic susceptibility of deep grey matter structures in patients with Clinically Isolated Syndrome (CIS) that is suggestive of multiple sclerosis (MS), as compared with age-matched healthy subjects.Methods: We compared 19 CIS patients to 20 age-matched, healthy controls. Scanning of the study subjects was performed on a 7T Philips Achieva system, using a 3-dimensional, T2*-weighted gradient echo acquisition. Phase data were first high-pass filtered, using a dipole fitting method, and then inverted to produce magnetic susceptibility maps. Region of interest (ROI) analysis was used to estimate magnetic susceptibility values for deep grey matter structures (caudate nucleus, putamen, globus pallidus, the thalamus and its pulvinar).Results: Significantly increased relative susceptibilities were found in the CIS group, compared with controls, for the caudate nucleus (p = < 0.01), putamen (p < 0.01), globus pallidus (p < 0.01) and pulvinar (p < 0.05). We found no significant nor consistent trends in the relationship between susceptibility and age for either the study controls or CIS patients, in any ROI (r(2) < 0.5; p > 0.05). In CIS patients, the time elapsed since the clinical event and the Expanded Disability Status Scale (EDSS) scores were not correlated with iron levels in any ROI (r(2) < 0.5; p > 0.05); however, a moderate correlation (r(2) = 0.3; p < 0.01) was found between the T1 lesion load and the mean susceptibility of the caudate nucleus.Conclusion: CIS patients showed an increased iron accumulation, as measured using susceptibility mapping of the deep grey matter, suggesting that iron changes did occur at the earlier stages of CIS disease.