Quantification of normal-appearing white matter tract integrity in multiple sclerosis: a diffusion kurtosis imaging study.
Quantification of normal-appearing white matter tract integrity in multiple sclerosis: a diffusion kurtosis imaging study.
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DOI：
10.1007/s00415-016-8118-z
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发表时间：
2016-06
影响因子：
6
通讯作者：
Inglese M
中科院分区：
文献类型：
--
作者：
de Kouchkovsky I;Fieremans E;Fleysher L;Herbert J;Grossman RI;Inglese M
我们的目的是使用新的弥散峰度成像衍生的白色物质束完整性（WMTI）指标来表征多发性硬化（MS）患者正常外观白色物质（NAWM）的病理变化的性质和程度，并调查这些WMTI指标和临床参数之间的关联。32例复发缓解型MS患者和19例年龄和性别匹配的健康对照者接受了MRI和神经系统检查。创建了平均扩散率、分数各向异性和WMTI指标（轴突内扩散率、轴突水分数、弯曲度以及轴向和径向轴突外扩散率）的地图。进行基于区域的空间统计分析以评估患者和对照之间NAWM的差异。还进行胼胝体的感兴趣区域分析以评估组差异并评估WMTI指标与疾病严重程度测量之间的相关性。与对照组相比，MS患者的平均扩散率和径向轴索外扩散率显著增加，而各向异性分数、轴索水分数、轴索内扩散率和迂曲度降低（p值范围为<0.001至< 0.05）。胼胝体中轴突水分数与扩展残疾状态量表评分显著相关（ρ =-0.39，p = 0.035）。除了轴向轴突外扩散率，所有指标均与符号数字模态测试评分相关（p值范围为0.001至< 0.05）。因此，WMTI指标对MS患者NAWM的变化敏感，并可能为标准扩散张量成像衍生指标提供更具病理特异性、临床意义和实用性的补充。
Our aim is to characterize the nature and extent of pathological changes in the normal-appearing white matter (NAWM) of patients with multiple sclerosis (MS) using novel diffusion kurtosis imaging-derived white matter tract integrity (WMTI) metrics, and to investigate the association between these WMTI metrics and clinical parameters. 32 patients with relapsing-remitting MS and 19 age- and gender-matched healthy controls underwent MRI and neurological examination. Maps of mean diffusivity, fractional anisotropy and WMTI metrics (intra-axonal diffusivity, axonal water fraction, tortuosity and axial and radial extra-axonal diffusivity) were created. Tract-based spatial statistics analysis was performed to assess for differences in the NAWM between patients and controls. A region of interest analysis of the corpus callosum was also performed to assess for group differences and to evaluate correlations between WMTI metrics and measures of disease severity. Mean diffusivity and radial extra-axonal diffusivity were significantly increased while fractional anisotropy, axonal water fraction, intra-axonal diffusivity and tortuosity were decreased in MS patients compared with controls (p values ranging from <0.001 to < 0.05). Axonal water fraction in the corpus callosum was significantly associated with the expanded disability status scale score (ρ = −0.39, p = 0.035). With the exception of the axial extra-axonal diffusivity, all metrics were correlated with the symbol digits modality test score (p values ranging from 0.001 to < 0.05). WMTI metrics are thus sensitive to changes in the NAWM of MS patients and might provide a more pathologically specific, clinically meaningful and practical complement to standard diffusion tensor imaging-derived metrics.