MR correlates of cerebral atrophy in patients with multiple sclerosis
MR correlates of cerebral atrophy in patients with multiple sclerosis
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DOI：
10.1007/s00415-002-0790-5
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发表时间：
2002-08-01
影响因子：
6
通讯作者：
Filippi, M
中科院分区：
文献类型：
--
作者：
De Stefano, N;Iannucci, G;Filippi, M
目的通过脑容量归一化测量值（NBV）与其他组织损伤磁共振测量值的关系，探讨多发性硬化症（MS）患者脑萎缩的体内相关性。背景脑萎缩在ms患者中弥漫性发生并逐渐加重，然而，导致该疾病脑萎缩的机制尚不完全清楚。方法对20例复发缓解型多发性硬化症患者行MRI检查，常规MRI评估NBV和脑t2高、t1低信号病变总体积。对脑内大部分正常组织进行质子磁共振成像和弥散张量磁共振成像，提供组织损伤指标，包括n -乙酰天冬氨酸与肌酸比（NAA/Cr）和平均扩散率（D / bar）。结果NBV值与脑平均(D)值（r = -0.58, p = 0.007）和NAA/Cr值（r = 0.67, p < 0.001）显著相关。当NAA/Cr和(D) over bar一起计算复合MR评分时，也发现了这些组织损伤标志物与NBV的关系（r = 0.70,p < 0.001）。相比之下，NBV值与平均病变(D)测量值、T-2和T-1加权脑MRi病变总体积无关。本研究表明，多发性硬化症的脑萎缩不仅仅是由于轴突的丧失，而是反映了一个涉及多种脑组织成分的更广泛的过程。在导致ms相关的不可逆脑萎缩的破坏过程中，对正常组织的损伤而不是宏观病变的范围和内在病理似乎是重要的。
Objective To investigate the in-vivo correlates of brain atrophy in patients with multiple sclerosis (MS) by assessing the relationship between normalized measures of brain volume (NBV) and other magnetic resonance (MR) measures of tissue damage. Background Brain atrophy diffusely occurs and progressively increases in patients with MS. Nevertheless, the mechanisms leading to brain atrophy in this disease are not fully understood. Methods MR examinations were performed in 20 patients with relapsing-remitting MS. Conventional MRI was used to assess NBV and total brain T2-hyperintense and T1-hypointense lesion volumes. Proton MR spectroscopic imaging and diffusion tensor MR imaging were also performed for large portions of brain containing mainly normal-appearing tissue to provide indices of tissue damage, including N-acetylaspartate to creatine ratio (NAA/Cr) and mean diffusivity ((D) over bar). Results Values of NBV correlated significantly with those of average (D) over bar brain (r = -0.58, p = 0.007) and NAA/Cr (r = 0.67, p < 0.001). The relationship of these markers of tissue damage to NBV was also found when NAA/Cr and (D) over bar were computed together in a composite MR score (r = 0.70,p < 0.001). In contrast, NBV values did not correlate with measurements of average lesion (D) over bar, T-2 and T-1 weighted total brain MRi lesion volumes. Conclusions This study suggests that brain atrophy in MS is not simply due to axonal loss, but rather reflects a more generalized process that involves various brain tissue components. Damage to the normal-appearing tissue rather than the extent and intrinsic pathology of macroscopic lesions seems to be important in the destructive process leading to MS-related irreversible cerebral atrophy.