A longitudinal study of MR diffusion changes in normal appearing white matter of patients with early multiple sclerosis
A longitudinal study of MR diffusion changes in normal appearing white matter of patients with early multiple sclerosis
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DOI：
10.1016/s0730-725x(02)00519-2
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发表时间：
2002-06-01
影响因子：
2.5
通讯作者：
Pozzilli, C
中科院分区：
文献类型：
--
作者：
Caramia, F;Pantano, P;Pozzilli, C
背景和目的：多发性硬化（MS）患者首次出现正常外观白色物质（NAWM）异常的阶段尚不清楚。我们的研究的目的是监测水扩散的变化，随着时间的推移，在NAWM的早期MS患者。方法：出连续一系列的患者参加了MR研究临床孤立综合征（CIS），我们选择了19名受试者谁完成了一年的随访。根据MS诊断的新标准，对基线和12个月时获得的MR扫描进行了审查。在基线和12个月时测量了患者和12名健康对照者的T2和T1加权图像上的病变负荷以及NAWM中的表观扩散系数的轨迹。在3例患者中，MS的诊断是在基线时基于MR进行的。13例患者在研究期间发生MS，3例患者的诊断仍然是“可能的MS”。在12个月的随访中，NAWM患者的TADC显著高于对照组，但在基线时并非如此（对照组平均tADC +/- sd = 0.745 +/- 0.02 mm（2）/sec X 10（-3）;患者平均tADC（12）+/- sd = 0.767 +/- 0.02 mm（2）/sec X 10（-3）; p < 0.02）。12个月时TADC和T2病变负荷显著相关（p < 0.01）。tADC（12）高于置信区间的患者在同一时间段的EDSS评分显著更高（EDSS 12 +/- sd分别= 1.9 +/- 0.5和= 1.1 +/- 0.4; p < 0.01）。这项研究表明，弥散MR不能检测到CIS患者NAWM的改变，提示MS。一年后，当大多数患者发展为MS时，NAWM的弥散MR异常变得明显。这些异常与T2病变负荷相关，并可能导致神经功能损害。(C)2002年爱思唯尔科技有限公司All rights reserved.
Background and purpose: The stage at which normal appearing white matter (NAWM) abnormalities first appear in multiple sclerosis (MS) is not clear. The aim of our study was to monitor water diffusion changes over time in NAWM of patients with early MS.Methods: Out of a consecutive series of patients enrolled in a MR study on clinically isolated syndrome (CIS), we selected 19 subjects who had completed a one year follow-up. The MR scans obtained at baseline and at 12 months were reviewed according to the new criteria on the diagnosis of MS. Lesion load on T2 and T1 weighted images and the trace of the apparent diffusion coefficient in NAWM were measured both at baseline and at 12 months in patients and in 12 healthy controls.Results: In three patients the diagnosis of MS was done at baseline based on MR. Thirteen patients developed MS during the study and in three patients the diagnosis remained "possible MS." TADC in NAWM in patients was significantly higher than in controls at the 12 months' follow-up but not at baseline (controls mean tADC +/- sd = 0.745 +/- 0.02 mm(2)/sec X 10(-3); patients mean tADC(12) +/- sd = 0.767 +/- 0.02 mm(2)/sec X 10(-3); p < 0.02). TADC and T2 lesion load at 12 months were significantly correlated (p < 0.01). Patients exhibiting tADC(12) above a confidence interval had a significantly greater EDSS score at the same time period (EDSS12 +/- sd = 1.9 +/- 0.5 and = 1.1 +/- 0.4 respectively; p < 0.01).Conclusions: This study suggests that diffusion MR cannot detect alterations in NAWM of patients with a CIS suggestive of MS. After one year, when most patients develop MS, diffusion MR abnormalities in NAWM become apparent. These abnormalities are correlated with T2 lesion load and may contribute to neurological impairment. (C) 2002 Elsevier Science Inc. All rights reserved.