Magnetization transfer changes in the normal appearing white matter precede the appearance of enhancing lesions in patients with multiple sclerosis
Magnetization transfer changes in the normal appearing white matter precede the appearance of enhancing lesions in patients with multiple sclerosis
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DOI：
10.1002/ana.410430616
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发表时间：
1998-06-01
影响因子：
11.2
通讯作者：
Comi, G
中科院分区：
文献类型：
--
作者：
Filippi, M;Rocca, MA;Comi, G
连续每月进行磁化传递（MT）成像，以评估多发性硬化（MS）患者在出现增强病变之前是否出现正常外观白色物质（NAWM）的变化。10例复发-缓解型MS患者在注射0.3mmol/kg钆-DTPA（Gd-DTPA）后20分钟行T1加权扫描，每4周1次，共3个月。在每个月的会议期间，MT和双回波扫描也进行了Gd-DTPA注射前。在共配准图像上，测量随后被增强病变累及的NAWM、同一切片上但在任何现有或未来MR异常之外的NAWM区域以及出现时的增强病变的MT比率（MTR）。发现48个新的增强病灶，在以前的扫描中没有相应的异常。他们的平均MTR为33.1%（+/-8.4%）。增强出现前3、2和1个月，NAWM的平均MTR（从对应于未来增强病变的区域测量）显著低于NAWM增强区域以外的平均MTR; MTR随着增强病变的临近而稳步下降。这些结果表明，MS患者NAWM的变化发生在病变在常规MRI扫描上变得明显之前。
Serial monthly magnetization transfer (MT) imaging was performed to evaluate whether a change of the normal appearing white matter (NAWM), which precedes the appearance of enhancing lesions, is seen in patients with multiple sclerosis (MS). Every 4 weeks for 3 months, 10 patients with relapsing-remitting MS were scanned with a T1-weighted sequence, 20 minutes after injection with 0.3 mmol/kg gadolinium-DTPA (Gd-DTPA). During each of the monthly sessions, MT and dual echo scans were also performed before Gd-DTPA injection. On coregistered images, the MT ratio (MTR) was measured in NAWM subsequently involved by enhancing lesions, in NAWM areas on the same slices but outside any present or future MR abnormality, and in enhancing lesions at the time of their appearance. Forty-eight new enhancing lesions with no corresponding abnormalities on previous scans were identified. Their average MTR was 33.1% (+/-8.4%). Three, 2, and 1 month before enhancement appearance, the mean MTR in NAWM, measured from areas corresponding to future enhancing lesions, was significantly lower than the mean MTR in NAWM outside enhancing areas; the MTR decreased steadily as the time when the enhanced lesion approached. These results suggest that changes in the NAWM of patients with MS occur before lesions become evident on conventional MRI scans.