Fast whole-brain three-dimensional macromolecular proton fraction mapping in multiple sclerosis.
Fast whole-brain three-dimensional macromolecular proton fraction mapping in multiple sclerosis.
复制标题
多发性硬化症的快速全脑三维大分子质子分数图谱。
DOI：
10.1148/radiol.14140528
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发表时间：
2015
期刊：
影响因子：
19.7
通讯作者：
JungHenson,LilyK
中科院分区：
文献类型：
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作者：
Yarnykh,VasilyL;Bowen,JamesD;Samsonov,Alexey;Repovic,Pavle;Mayadev,Angeli;Qian,Peiqing;Gangadharan,Beena;Keogh,BartP;Maravilla,KennethR;JungHenson,LilyK
目的评价全脑大分子质子分数（MPFmacromolecular proton fraction，简称mpf大分子质子分数）快速定位在多发性硬化症（m多发性硬化症）中的临床应用价值，并将MPFmacromolecular质子分数与已建立的组织损伤定量磁共振（MR）成像指标进行比较，包括磁化转移（mt磁化转移）比和松弛率（R1）。材料和方法在这项机构审查委员会批准并符合hipaa标准的研究中，14名健康对照受试者、18名复发缓解型多发性硬化症（rrms松弛缓解型MS）患者和12名继发进行性多发性硬化症（spmss继发进行性MS）患者提供了书面知情同意并接受了3-T MR成像。利用单点法从mt磁化转移加权图像和R1图重建了三维mpf大分子质子分数图。采用方差分析比较各组正常白质（WMwhite matter）、灰质（GMgray matter）和病变的平均mpf大分子质子分数、R1和mt磁化转移比。采用Hotelling-Williams检验比较影像学数据与临床评分（扩展残疾状态量表[EDSS]和多发性硬化症功能复合量表[MSFCMS功能复合量表]）的相关性（pearson）。结果与对照组相比，rrms松弛缓解组患者wm白质、gmgrey质、mpf大分子质子分数分别下降6.5% （P< 0.005）和5.4% （P< 0.05）。mpf大分子质子分数在spms继发性进展性mss中相对于rrms松弛缓解型mss， wm白质，gm灰质和病变分别减少6.4% (P< 0.005), 13.4% （P< 0.005）和11.7% （P< 0.05）。eds扩展残疾状态量表和MSFCMS功能组合显示与mpfgm灰质大分子质子分数的相关性最强（r= - 0.74和0.81，P< 0.001），其次是wm白质（r= - 0.57和0.72，P< 0.01）和病变（r= - 0.42和0.50，P< 0.05）。各组织中R1和mt磁化转移率与临床评分的相关性显著低于gm灰质和mpf大分子质子分数（P< 0.05）。结论mpf大分子质子分割成像能够定量评估正常脑组织的脱髓鞘，并显示mms多发性硬化症GMgray质损伤的主要临床相关性。mpf大分子质子分数在检测多发性硬化症相关组织变化方面优于mt磁化转移比和R1。©rsna, 2014
PurposeTo evaluate the clinical utility of fast whole-brain macromolecular proton fraction (MPFmacromolecular proton fraction) mapping in multiple sclerosis (MSmultiple sclerosis) and compare MPFmacromolecular proton fractionwith established quantitative magnetic resonance (MR) imaging measures of tissue damage including magnetization transfer (MTmagnetization transfer) ratio and relaxation rate (R1).Materials and MethodsIn this institutional review board–approved and HIPAA-compliant study, 14 healthy control participants, 18 relapsing-remitting MSmultiple sclerosis(RRMSrelaxing-remitting MS) patients, and 12 secondary progressive MSmultiple sclerosis(SPMSsecondary progressive MS) patients provided written informed consent and underwent 3-T MR imaging. Three-dimensional MPFmacromolecular proton fractionmaps were reconstructed from MTmagnetization transfer-weighted images and R1 maps by the single-point method. Mean MPFmacromolecular proton fraction, R1, and MTmagnetization transferratio in normal-appearing white matter (WMwhite matter), gray matter (GMgray matter), and lesions were compared between subject groups by using analysis of variance. Correlations (Pearsonr) between imaging data and clinical scores (Expanded Disability Status Scale [EDSS] and MSmultiple sclerosisFunctional Composite [MSFCMS functional composite]) were compared by using Hotelling-Williams test.ResultsRRMSrelaxing-remitting MSpatients had lower WMwhite matterand GMgray matterMPFmacromolecular proton fractionthan controls, with percentage decreases of 6.5% (P< .005) and 5.4% (P< .05). MPFmacromolecular proton fractionin SPMSsecondary progressive MSwas reduced relative to RRMSrelaxing-remitting MSin WMwhite matter, GMgray matter, and lesions by 6.4% (P< .005), 13.4% (P< .005), and 11.7% (P< .05), respectively. EDSSExpanded Disability Status Scaleand MSFCMS functional compositedemonstrated strongest correlations with MPFmacromolecular proton fractionin GMgray matter(r= −0.74 and 0.81;P< .001) followed by WMwhite matter(r= −0.57 and 0.72;P< .01) and lesions (r= −0.42 and 0.50;P< .05). R1 and MTmagnetization transferratio in all tissues were significantly less correlated with clinical scores than GMgray matterMPFmacromolecular proton fraction(P< .05).ConclusionMPFmacromolecular proton fractionmapping enables quantitative assessment of demyelination in normal-appearing brain tissues and shows primary clinical relevance of GMgray matterdamage in MSmultiple sclerosis. MPFmacromolecular proton fractionoutperforms MTmagnetization transferratio and R1 in detection of MSmultiple sclerosis-related tissue changes.© RSNA, 2014