Perfusion and Diffusion Abnormalities of Multiple Sclerosis Lesions and Relevance of Classified Lesions to Disease Status.
Perfusion and Diffusion Abnormalities of Multiple Sclerosis Lesions and Relevance of Classified Lesions to Disease Status.
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DOI：
10.4172/2155-9562.s12-012
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发表时间：
2014-04
期刊：
影响因子：
--
通讯作者：
Jiang Q
中科院分区：
文献类型：
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作者：
Li L;Chopp M;Nejad-Davarani SP;Jafari-Khouzani K;Patel SC;Budaj J;Lu M;Elias SB;Cerghet M;Jiang Q
血流动力学异常和白质（WM）完整性破坏是多发性硬化症（MS）病变病理生理的重要组成部分。然而，具有不同程度血流动力学和结构损伤的分层病变在疾病状态中的作用仍有待探讨。我们验证了以下假设：分别由脑血容量（CBV）和分数各向异性（FA）评估的血流动力学和结构损伤表征了组织损伤的程度，而具有实质性组织破坏的病变负荷反映了疾病状态，因此与临床残疾有关。7名复发缓解型MS患者和7名健康对照者接受灌注、扩散和常规MRI扫描。基于T2-FLAIR和t1加权图像对WM斑块进行分类。图像共配准后，估计三种不同病变类型（活动性、t1 -低信号和t1 -等信号病变）的CBV和FA值，并与对照组WM的CBV和FA值进行比较。总共评估了1135个病变。测定脑容量，并分析脑萎缩、病变体积与临床残疾的相关性。与正常WM相比，t1 -低信号灶CBV和FA明显降低，而t1 -等信号灶CBV和FA变化不明显。然而，在活动性病变中检测到CBV增加而FA显著降低。活动性和t1 -低信号病变之间存在密切的空间关系。以t1 -低血压+活动性病变体积为代表的病变负荷与脑萎缩显著相关，脑萎缩与临床残疾严重程度显著相关。CBV和FA的独特组合表征了特定病变类型的状态。严重的结构损伤不仅发生在t1低信号病变中，也与活动性病变有关。具有广泛结构损伤的病变负担提供了一种图像指标，指示疾病状态。
Hemodynamic abnormality and disruption of white matter (WM) integrity are significant components in the pathophysiology of multiple sclerosis (MS) lesions. However, the roles of stratified lesions with distinct degrees of hemodynamic and structural injury in disease states remain to be explored. We tested the hypothesis that hemodynamic and structural impairment, as assessed by cerebral blood volume (CBV) and fractional anisotropy (FA), respectively, characterizes the extent of tissue injury, and the load of lesion with substantial tissue destruction would reflect the disease status and therefore, would be related to clinical disability. Seven relapsing-remitting MS patients and seven healthy controls underwent perfusion, diffusion and conventional MRI scans. Based on T2-FLAIR and T1-weighted image, WM plaques were classified. After image coregistration, values of CBV and FA were estimated in three distinct lesion types (active, T1-hypointense and T1-isointense lesion) and compared with those obtained in WM from controls. A total of 1135 lesions were evaluated. Brain volumetric measurement and correlative analysis between brain atrophy, lesion volume and clinical disability were also performed. Compared with normal WM, significantly reduced CBV and FA were present in the T1-hypointense lesion, while insignificant changes in both parameters were exhibited in the T1-isointense lesion. However, increased CBV but significantly decreased FA was detected in the active lesion. A close spatial relationship between active and T1-hypointense lesion was observed. Lesion load represented by T1-hypointense plus active lesion volume significantly correlated with brain atrophy, which, in turn, significantly correlated with the severity of clinical disability. A distinct combination of CBV and FA characterizes the status of a specific lesion type. A severe structural impairment does not solely occur in the T1-hypointense lesion, but is also associated with the active lesion. The burden of the lesion with extensive structural damage provides an image index, indicative of disease status.