Whole-brain T1 mapping in multiple sclerosis: Global changes of normal-appearing gray and white matter
Whole-brain T1 mapping in multiple sclerosis: Global changes of normal-appearing gray and white matter
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DOI：
10.1148/radiol.2403050569
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发表时间：
2006-09-01
期刊：
影响因子：
19.7
通讯作者：
Pouwels, Petra J. W.
中科院分区：
文献类型：
--
作者：
Vrenken, Hugo;Geurts, Jeroen J. G.;Pouwels, Petra J. W.
目的：前瞻性研究多发性硬化症（MS）中正常白质（WM）和正常灰质（GM）的T1变化是整体还是局部及其与疾病类型的关系。 材料和方法：机构伦理审查委员会批准的研究；获得书面知情同意书。采用三维快速低角度翻转角阵法获得了 67 名多发性硬化症患者和 24 名健康对照者的全脑 T1 图，并对 B1 缺陷进行了校正。对整体正常出现的 WM 和 GM 的 T1 直方图参数进行方差分析。采用多层次方法分析区域平均 T1 值。进行多元线性回归分析以调查与临床残疾和整体萎缩的关联。对于患者，确定 T2 病变负荷。 结果：MS 患者的正常 WM 的 T1 直方图峰值位置（继发性进展性 [SP] MS 中为 792 毫秒 +/- 36）明显高于对照受试者（746 毫秒 +/- 23），并且明显更宽和更低（所有 P < .001）。皮质正常外观 GM 的直方图显着偏移（对照受试者中的峰值位置为 1263 毫秒 +/- 44，SP MS 患者中的峰值位置为 1355 毫秒 +/- 62）（P < .001）。 SP MS 的直方图峰值位置显着高于复发缓解型 (RR) 和原发进展型 MS (P < .05)。在 SP 疾病中，至少 31% 的正常 WM 和 20% 的皮质正常 GM 受到影响。在 MS 中，所有正常 WM 区域和皮质正常 GM 区域的 T1 均显着升高（全部 P < .01），但仅在深部 GM 的丘脑中升高（P < .05）。皮质 T1 直方图峰值位置与临床残疾相关； T2 病变负荷则不然。结论：结果表明，整体疾病过程影响 MS 中正常表现的 WM 和 GM 的大部分，并且 SP MS 的影响比 RR MS 更差。
Purpose: To prospectively investigate whether T1 changes in normal-appearing white matter (WM) and normal-appearing gray matter (GM) in multiple sclerosis (MS) are global or regional and their relationship to disease type.Materials and Methods: The institutional ethics review board approved study; written informed consent was obtained. Whole-brain T1 maps were obtained in 67 patients with MS and 24 healthy control subjects with three-dimensional fast low-angle shot flip angle-array method, with correction for B1 imperfections. Analysis of variance was performed on T1 histogram parameters of global normal-appearing WM and GM. Regional mean T1 values were analyzed with a multilevel approach. Multiple linear regression analysis was performed to investigate associations with clinical disability and overall atrophy. For patients, T2 lesion load was determined.Results: T1 histograms of normal-appearing WM had significantly higher peak positions for patients with MS (792 msec +/- 36 in secondary progressive [SP] MS) than for control subjects (746 msec +/- 23) and were significantly broader and lower (all P < .001). Histograms for cortical normal-appearing GM were significantly shifted ( peak positions, 1263 msec +/- 44 in control subjects and 1355 msec +/- 62 in patients with SP MS) (P < .001). Histogram peak positions were significantly higher in SP MS than in relapsing-remitting (RR) and primary progressive MS (P < .05). In SP disease, at least 31% of normal-appearing WM and 20% of cortical normal-appearing GM were affected. In MS, T1 was significantly elevated in all normal-appearing WM and cortical normal-appearing GM regions (all P < .01) but was elevated only in the thalamus in deep GM (P < .05). Cortical T1 histogram peak position was associated with clinical disability; T2 lesion load was not.Conclusion: Results suggest that a global disease process affects large parts of both normal-appearing WM and GM in MS and effects are worse for SP MS than for RR MS.