Clinically feasible MTR is sensitive to cortical demyelination in MS
Clinically feasible MTR is sensitive to cortical demyelination in MS
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DOI：
10.1212/wnl.0b013e31827deb99
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发表时间：
2013-01-01
期刊：
影响因子：
9.9
通讯作者：
Trapp, Bruce D.
中科院分区：
文献类型：
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作者：
Chen, Jacqueline Tien-Hsiang;Easley, Kathryn;Trapp, Bruce D.
目的：目前尚无临床可行的影像学方法能有效检测多发性硬化症（MS）患者的皮质脱髓鞘。本研究的目的是确定临床可行的磁化转移比（MTR）成像是否对MS皮质脱髓鞘敏感。方法：对7例最近死亡的MS患者进行原位MRI，使用临床可行的3 T序列，包括相对高分辨率的t1加权和质子密度加权图像，有/没有磁化转移脉冲，用于计算MTR。大脑被迅速取出并置于固定液中。每个大脑的多个皮质区域进行髓磷脂蛋白脂蛋白免疫染色，并分类为大部分髓鞘（MMctx），大部分脱髓鞘（MDctx）或中度脱髓鞘（IDctx）。在皮质切片上进行核磁共振成像，以便识别每个皮质切片对应的皮层，以及相邻的皮质下白质（WM）。计算每个皮质区域的平均皮质MTR归一化为平均WM MTR。线性混合效应模型用于检验脱髓鞘皮层的平均归一化皮层MTR是否显著降低。结果：我们发现，与MMctx（脱髓鞘皮质：最小二乘平均值[LSM] = 0.797, SE = 0.007; MMctx: LSM = 0.837, SE = 0.006; p = 0.01, n = 89）相比，任何脱髓鞘皮质组织（IDctx或MDctx）的平均归一化皮质MTR显著降低。结论：该结果表明，临床可行的MTR成像对皮质脱髓鞘敏感，并表明MTR将成为帮助检测MS神经学患者MS皮质病变的有用工具(R) 2013；80:246 - 252
Objective: Presently there is no clinically feasible imaging modality that can effectively detect cortical demyelination in patients with multiple sclerosis (MS). The objective of this study is to determine if clinically feasible magnetization transfer ratio (MTR) imaging is sensitive to cortical demyelination in MS.Methods: MRI were acquired in situ on 7 recently deceased patients with MS using clinically feasible sequences at 3 T, including relatively high-resolution T1-weighted and proton density-weighted images with/without a magnetization transfer pulse for calculation of MTR. The brains were rapidly removed and placed in fixative. Multiple cortical regions from each brain were immunostained for myelin proteolipid protein and classified as mostly myelinated (MMctx), mostly demyelinated (MDctx), or intermediately demyelinated (IDctx). MRIs were registered with the cortical sections so that the cortex corresponding to each cortical section could be identified, along with adjacent subcortical white matter (WM). Mean cortical MTR normalized to mean WM MTR was calculated for each cortical region. Linear mixed-effects models were used to test if mean normalized cortical MTR was significantly lower in demyelinated cortex.Results: We found that mean normalized cortical MTR was significantly lower in cortical tissue with any demyelination (IDctx or MDctx) compared to MMctx (demyelinated cortex: least-squares mean [LSM] = 0.797, SE = 0.007; MMctx: LSM = 0.837, SE = 0.006; p = 0.01, n = 89).Conclusions: This result demonstrates that clinically feasible MTR imaging is sensitive to cortical demyelination and suggests that MTR will be a useful tool to help detect MS cortical lesions in living patients with MS. Neurology (R) 2013;80:246-252