Reduced NAA-levels in the NAWM of patients with MS is a feature of progression. A study with quantitative magnetic resonance spectroscopy at 3 Tesla.
Reduced NAA-levels in the NAWM of patients with MS is a feature of progression. A study with quantitative magnetic resonance spectroscopy at 3 Tesla.
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DOI：
10.1371/journal.pone.0011625
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发表时间：
2010-07-20
期刊：
影响因子：
3.7
通讯作者：
Kristoferitsch W
中科院分区：
文献类型：
--
作者：
Aboul-Enein F;Krssák M;Höftberger R;Prayer D;Kristoferitsch W
磁共振波谱（MRS）中N-乙酰天冬氨酸（NAA）水平降低可显示轴突损伤，即使在正常外观的白色物质（NAWM）中也是如此。脱髓鞘和轴突变性是多发性硬化症（MS）的标志。确定复发缓解型（RRMS）和继发性进展型MS（SPMS）患者远离局灶性病变的NAWM中轴突变性的程度。37例临床确诊的MS患者（27例RRMS，10例SPMS）和8例对照。我们使用2D 1H-MR化学位移成像（TR = 1500 ms，TE = 135 ms，标称分辨率1ccm），在3 T下工作，以评估额顶NAWM的代谢模式。 NAA与肌酸（Cr）和胆碱（Cho）的比值以及NAWM中代谢物的绝对浓度在解剖T2加权MR图像上的白色物质匹配的每个体素中进行测量。NAA、Cr、Cho的绝对浓度及代谢物比值在RRMS组与对照组之间均无显著性差异。在SPMS中，NAA/Cr比和NAA和Cr的绝对浓度与RRMS和对照组相比显著降低。在我们的研究中，SPMS患者，而不是RRMS患者的特点是低NAA水平。MS患者NAWM中NAA水平降低是疾病进展的一个特征。
Reduced N-acetyl-aspartate (NAA) levels in magnetic resonance spectroscopy (MRS) may visualize axonal damage even in the normal appearing white matter (NAWM). Demyelination and axonal degeneration are a hallmark in multiple sclerosis (MS). To define the extent of axonal degeneration in the NAWM in the remote from focal lesions in patients with relapsing-remitting (RRMS) and secondary progressive MS (SPMS). 37 patients with clinical definite MS (27 with RRMS, 10 with SPMS) and 8 controls were included. We used 2D 1H-MR-chemical shift imaging (TR = 1500ms, TE = 135ms, nominal resolution 1ccm) operating at 3Tesla to assess the metabolic pattern in the fronto–parietal NAWM. Ratios of NAA to creatine (Cr) and choline (Cho) and absolute concentrations of the metabolites in the NAWM were measured in each voxel matching exclusively white matter on the anatomical T2 weighted MR images. No significant difference of absolute concentrations for NAA, Cr and Cho or metabolite ratios were found between RRMS and controls. In SPMS, the NAA/Cr ratio and absolute concentrations for NAA and Cr were significantly reduced compared to RRMS and to controls. In our study SPMS patients, but not RRMS patients were characterized by low NAA levels. Reduced NAA-levels in the NAWM of patients with MS is a feature of progression.
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