Use of combined conventional and quantitative MRI to quantify pathology related to cognitive impairment in multiple sclerosis
Use of combined conventional and quantitative MRI to quantify pathology related to cognitive impairment in multiple sclerosis
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DOI：
10.1136/jnnp.2006.112177
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发表时间：
2008-04-01
影响因子：
11
通讯作者：
Constantinescu, C. S.
中科院分区：
文献类型：
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作者：
Lin, X.;Tench, C. R.;Constantinescu, C. S.
背景：认知功能障碍是多发性硬化症(MS)的常见和早期表现之一。目的：通过常规磁共振成像(MRI)、磁化转移成像(MTI)和弥散张量成像(DTI)，探讨多发性硬化症(MS)患者和13例年龄、性别相匹配的正常对照脑部常规双回波、DTI和MTI检查结果，以探讨认知功能异常与常规磁共振成像(MRI)、磁化传递成像(MTI)和弥散张量成像(DTI)检查结果之间的关系。来自CC的体素使用基于声道成像的算法来识别。测量CC的平均表观弥散系数(ADCA(Fv))和MT比率。在高分辨率MRI图像的正中矢状面上进行边缘检测，测量胼胝体面积(CCA)。采用扩展残疾状态量表(EDSS)和起搏听觉系列加法测验(PASAT)进行评分。结果：9例(25%)患者存在认知障碍。认知损害组的CCA明显小于对照组(608.2(428.6-713.0)mm(2)vs 674.2(585.8-754.4)mm~2，p=0.04)。CC组MT比值明显低于对照组(0.41(0.39~0.042)vs0.43(0.42~0.43)，P<0.001)。CC组ADC值高于对照组(0.94(0.89~0.99)vs0.87(0.85~0.89)，p<0.001)。PASAT与平均MT比率(r=0.47，p=0.0046)、平均ADC值(r=-0.53，p=0.0012)、CCA(r=0.42，p=0.0012)和总T-2病变负荷(r=-0.4，p=0.017)相关，而与CC内T2病变负荷(r=-0.24，p=0.16)、病程(r=0.2，p=0.24)、EDSS(r=-0.27，p=0.27)无相关性。P=0.12)。结论：ADC(Av)、MTR和萎缩指标可能是检测MS患者认知损害相关的细微宏观和微观改变的敏感方法。
Background: Cognitive impairment is one of the frequent and early findings in multiple sclerosis ( MS).Objective: To determine the relation between cognitive abnormalities and the extent of macroscopic and microscopic tissue damage in the corpus callosum (CC), revealed by conventional magnetic resonance imaging (MRI), magnetisation transfer imaging (MTI) and diffusion tensor imaging (DTI).Methods: Conventional dual-echo, DTI and MTI of the brain were obtained from 36 patients with relapsing remitting (RR) MS, and 13 age and gender matched normal controls. Voxels from CC were identified using a tractography based algorithm. Mean apparent diffusion coefficient (ADCa(fv)) and MT ratio were measured for the CC as defined by tractography. Corpus callosum area (CCA) was measured using edge detection on the midsagittal slice on high resolution MRI images. The Expanded Disability Status Scale (EDSS) and Paced Auditory Serial Addition Test (PASAT) were scored.Results: Nine patients (25%) were found to be cognitively impaired. The CCA was not significantly different in the whole cohort of patients from controls (608.2 (428.6 - 713.0) mm(2) vs 674.2 (585.8 - 754.4) mm2, p = 0.1), but was smaller in cognitively impaired than unimpaired group (417 ( 290 - 634) mm2 vs 652 ( 511 - 718) mm2, p = 0.04). The mean MT ratio of CC in patients was lower than in controls (0.41 (0.39 - 0.042) vs 0.43 (0.42 - 0.43), p, < 0.001). The ADC(av) in the CC in patients was higher than in controls (0.94 (0.89 - 0.99) vs 0.87 (0.85 - 0.89), p, 0.001). PASAT was correlated with mean MT ratio (r = 0.47, p = 0.0046), ADC(av) (r = -0.53, p = 0.0012), CCA (r = 0.42, p = 0.01) and total T-2 lesion load (r = -0.4, p = 0.017), but not with T2 lesion load within the CC ( r= -0.24, p = 0.16), disease duration ( r= 0.2, p= 0.24) or EDSS ( r= -0.27, p= 0.12).Conclusions: ADC(av), MTR and atrophy measures in the CC may offer a sensitive method detecting subtle macroscopic and microscopic changes associated with cognitive impairment in MS.