THE LONGSTANDING MS LESION - A QUANTITATIVE MRI AND ELECTRON-MICROSCOPIC STUDY
THE LONGSTANDING MS LESION - A QUANTITATIVE MRI AND ELECTRON-MICROSCOPIC STUDY
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DOI：
10.1093/brain/114.3.1271
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发表时间：
1991-06-01
期刊：
影响因子：
14.5
通讯作者：
MCDONALD, WI
中科院分区：
文献类型：
--
作者：
BARNES, D;MUNRO, PMG;MCDONALD, WI
关于导致多发性硬化症（MS）进行性且最终不可逆的组织损伤的事件顺序，仍有一些重要问题未得到解答。本研究旨在利用定量和钆 - 二乙三胺五乙酸（Gd - DTPA）增强磁共振成像（MRI）技术，研究长期存在的MS病灶内血脑屏障的病理特征及其功能。对一例单独的MS死后病灶的超微结构表现与MRI结果进行了关联分析。MRI和超微结构分析均显示慢性病灶存在相当大的异质性：一些是“闭合”的，没有可检测到的细胞外水，但大多数是“开放”的，细胞外空间扩大至组织面积的87%。这种不同程度的扩张可能是由于轴突丢失程度不同所致。仅在17%的病灶中发现血脑屏障受损的证据，其严重程度低于急性病灶，可能是由先前反复的炎症损伤所致。这些发现表明随着病灶时间的推移，轴突会逐渐丢失。这种丢失可能与疾病的临床进展有关。
Important questions remain unanswered about the sequence of events leading to progressive and ultimately irreversible tissue damage in MS. This study was designed to investigate the pathological characteristics of, and function of, the blood-brain barrier within longstanding MS lesions using quantitative and Gd-DTPA enhanced MRI techniques. The ultrastructural appearances of postmortem lesions from a single, separate case of MS have been correlated with the MRI findings. Both MRI and ultrastructural analysis revealed considerable heterogeneity in the chronic lesions: some are 'closed' with no detectable extracellular water, but most are 'open' and show expansion of the extracellular space to as much as 87% of tissue area. This variable expansion probably results from differing degrees of axonal loss. Evidence of blood-brain barrier damage was found in only 17% of lesions, was less severe than that seen in acute lesions, and may result from repeated previous inflammatory insults. The findings imply progressive axonal loss in lesions as they age. It is possible that this loss is related to clinical progression of the disease.