Infratentorial atrophy on magnetic resonance imaging and disability in multiple sclerosis
Infratentorial atrophy on magnetic resonance imaging and disability in multiple sclerosis
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DOI：
10.1093/brain/122.2.291
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发表时间：
1999-02-01
期刊：
影响因子：
14.5
通讯作者：
Blumhardt, LD
中科院分区：
文献类型：
--
作者：
Edwards, SGM;Gong, QY;Blumhardt, LD
中枢神经系统组织体积的损失可能是多发性硬化症中固定神经功能障碍的一个指标，最近的磁共振研究显示临床残疾评分与颈脊髓横截面积之间存在一定的关系。为了进一步探讨多发性硬化症萎缩与残疾之间的关系，我们对41例患者（21例为复发缓解型多发性硬化症，20例为继发性进行性多发性硬化症）进行了横断面研究，从mri中估计了幕下结构的体积。我们使用了现代设计立体学的Cavalieri方法和点计数来估计脑干的体积。通过MPRAGE（磁化制备快速采集梯度回波）序列获得的三维mri图像显示，颈上（C1-C3）脊髓的体积与扩展残疾状态量表相应功能评分得出的脊髓综合评分（r = -0.50, P < 0.01）、小脑（r = 0.49, P < 0.01）和脑干（r = 0.34, P < 0.01）的体积呈显著相关。上颈髓体积（r = -0.39, P < 0.01）与病程显著相关，脑干或小脑体积与病程无显著相关。mri估计的结构体积可以提供轴突和/或髓鞘损失的简单指数，这是多发性硬化症中不可逆损伤和残疾的假定病理底物。
Loss of tissue volume in the central nervous system may provide an index of fixed neurological dysfunction in multiple sclerosis, Recent magnetic resonance studies have shown a modest relationship between clinical disability rating scores and transverse sectional area of the cervical spinal cord. To explore further the relationship between atrophy and disability in multiple sclerosis, we estimated the volumes of infratentorial structures from MRIs in a cross-sectional study of 41 patients, 21 with relapsing-remitting multiple sclerosis and 20 with secondary progressive multiple sclerosis, We used the Cavalieri method of modern design stereology with point counting to estimate the volume of brainstem, cerebellum and upper cervical spinal cord from three-dimensional MRIs acquired with an MPRAGE (Magnetization-prepared Rapid Acquisition Gradient Echo) sequence, The volume of the upper (C1-C3) cervical spinal cord was significantly correlated with a composite spinal cord score derived from the appropriate Functional Scale scores of the Expanded Disability Status Scale (r = -0.50, P < 0.01), The cerebellar (r = 0.49, P < 0.01) and brainstem (r = 0.34, P < 0.05) volumes correlated with the Scripp's Neurological Disability Rating Scale scores, The upper cervical cord volumes (r = -0.39, P < 0.01), but not the brainstem or cerebellar volumes, were significantly associated with disease duration. MRI-estimated structural volumes may provide a simple index of axonal and/or myelin loss, the presumed pathological substrates of irreversible impairment and disability in multiple sclerosis.