Diffusion-tensor MR imaging of corticospinal tract in amyotrophic lateral sclerosis and progressive muscular atrophy
Diffusion-tensor MR imaging of corticospinal tract in amyotrophic lateral sclerosis and progressive muscular atrophy
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DOI：
10.1148/radiol.2371041506
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发表时间：
2005-10-01
期刊：
影响因子：
19.7
通讯作者：
Murri, L
中科院分区：
文献类型：
--
作者：
Cosottini, M;Giannelli, M;Murri, L
目得：前瞻性评价进行性肌萎缩症（PMA）和肌萎缩侧索硬化症（ALS）患者皮质脊髓束损伤的几个弥散张量磁共振（MR）成像指标（平均弥散度[MD]，各向异性分数[FA]和特征值）。材料和方法：本研究获得了机构审查委员会的批准，并获得所有受试者的书面知情同意书。8例男性PMA患者（平均年龄，63岁+/- 13 [标准差]），18例ALS患者（14名男性和4名女性;平均年龄，64岁± 7岁）和12名对照受试者（四男八女;平均年龄，65岁+/- 6）进行了扩散张量MR成像，其中25个自旋回波回波平面成像扩散加权图像（B = 1000 sec/mm（2））。MD和FA沿着皮质脊髓束在每个患者和受试者进行了测量。利用弥散张量特征值评价患者弥散沿着和垂直于纤维束的变化。与对照组相比，PMA患者和ALS患者的弥散张量成像指数的差异采用Mann-Whitney检验进行评估。采用Pearson和斯皮尔曼秩相关检验估计弥散张量成像指数与临床变量之间的相关性。与MD相比（697.1 X 10（-6）mm（2）/sec +/- 28.1）和FA（0.585 0.032）在对照组中，MD通常显著增加（734.7 × 10（-6）mm（2）/sec +/- 41.2，P = .035），FA显著降低（0.534 +/- 0.053，P = 0.037），而PMA患者的这些参数无显著变化（MD，707.0 X 10（-6）mm（2）/sec +/-44.2; FA，0.559 +/-0.028）。扩散张量特征值的估计显示正常的扩散沿着纤维束在所有患者中，而扩散增加正交纤维束仅在典型的ALS患者。在ALS患者中，MD与病程相关，FA与病情严重程度相关。结论：扩散张量MR成像显示ALS患者皮质脊髓束受损，而PMA患者无此改变。(c)RSNA，2005年。
PURPOSE: To prospectively evaluate several diffusion-tensor magnetic resonance (MR) imaging indexes (mean diffusivity [MD], fractional anisotropy [FA], and eigenvalues) of corticospinal tract impairment in patients with progressive muscular atrophy (PMA) and patients with amyotrophic lateral sclerosis (ALS).MATERIALS AND METHODS: This study had institutional review board approval, and written informed consent was obtained from all subjects. Eight male patients with PMA (mean age, 63 years +/- 13 [standard deviation]), eighteen patients with ALS (14 men and four women; mean age, 64 years +/- 7), and twelve control subjects (four men and eight women; mean age, 65 years +/- 6) underwent diffusion-tensor MR imaging at which 25 spin-echo echo-planar imaging diffusion-weighted images (b = 1000 sec/mm(2)) were acquired along noncollinear directions. MD and FA were measured along the corticospinal tracts in each patient and subject. Changes in diffusion along and orthogonal to fiber bundles in patients were evaluated by using diffusion-tensor eigenvalues. Differences in diffusion-tensor imaging indexes between patients with PMA and those with ALS, as compared with these indexes in control subjects, were evaluated with Mann-Whitney testing. Correlations between diffusion-tensor imaging indexes and clinical variables were estimated with Pearson and Spearman rank correlation testing.RESULTS: As compared with MD (697.1 X 10(-6) mm(2) /sec +/- 28.1) and FA (0.585 0.032) in control subjects, MD was typically significantly increased (734.7 X 10(-6) mm(2)/sec +/- 41.2, P = .035) and FA significantly decreased (0.534 +/- 0.053, P = .037) along the corticospinal tracts in patients with ALS, while these parameters showed no significant change in patients with PMA (MD, 707.0 X 10(-6) mm(2)/sec +/- 44.2; FA, 0.559 +/- 0.028). Estimation of diffusion-tensor eigenvalues revealed normal diffusion along fiber tracts in all patients, while diffusion was increased orthogonal to fiber tracts only in patients with typical ALS. In patients with ALS, MD correlated with disease duration while FA correlated with disease severity.CONCLUSION: Diffusion-tensor MR imaging reveals corticospinal tract impairment in ALS but not in PMA. (c) RSNA, 2005.