Quantitative MRI shows cerebral microstructural damage in hemolytic-uremic syndrome patients with severe neurological symptoms but no changes in conventional MRI
Quantitative MRI shows cerebral microstructural damage in hemolytic-uremic syndrome patients with severe neurological symptoms but no changes in conventional MRI
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DOI：
10.1007/s00234-013-1176-3
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发表时间：
2013-07-01
期刊：
影响因子：
2.8
通讯作者：
Ding, Xiao-Qi
中科院分区：
文献类型：
--
作者：
Weissenborn, Karin;Bueltmann, Eva;Ding, Xiao-Qi
产滋贺毒素大肠杆菌感染相关溶血性尿毒症综合征（STEC-HUS）的严重神经系统症状通常不伴有或仅伴有轻度脑磁共振成像（MRI）改变。本研究旨在分析定量MRI是否能够显示常规MRI无法显示的脑病理改变，在9例STEC-HUS相关的严重神经系统症状，但不明显的脑MRI表现的参数T2弛豫时间，相对质子密度（PD），表观扩散系数（ADC），和分数各向异性（FA）的地图生成。这些参数的定量值在基底节，丘脑，额叶和顶叶的白色物质进行了测量，并与9个年龄和性别匹配的对照组进行了比较。PD和ADC无明显改变。患者尾状核头部FA值明显降低（P < 0.01），T2弛豫时间延长提示患者脑组织微结构损伤，尽管MRI表现不明显。T2弛豫测定法可作为评估代谢毒性脑综合征的补充工具。
Severe neurological symptoms in Shiga toxin-producing Escherichia coli infection associated hemolytic-uremic syndrome (STEC-HUS) are often accompanied by none or only mild alterations of cerebral magnetic resonance imaging (MRI). This study aims to analyze if quantitative MRI is able to reveal cerebral pathological alterations invisible for conventional MRI.In nine patients with STEC-HUS associated severe neurological symptoms but inconspicuous cerebral MRI findings maps of the parameters T2 relaxation time, relative proton density (PD), apparent diffusion coefficient (ADC), and fractional anisotropy (FA) were generated. Quantitative values of these parameters were measured at the basal ganglia, thalamus, and white matter of the frontal and parietal lobe and compared to those of nine age- and sex-matched controls.Significant T2 prolongation (p < 0.01) was found in the basal ganglia of all patients compared to controls. PD and ADC were not significantly altered. A significant reduction of FA in patients was seen at caput nuclei caudati (p < 0.01).Prolonged T2 relaxation time indicates cerebral microstructural damages in these patients despite their inconspicuous MRI findings. T2 relaxometry could be used as a complementary tool for the assessment of metabolic-toxic brain syndromes.