A pilot MRI study of white and grey matter involvement by multiple sclerosis spinal cord lesions
A pilot MRI study of white and grey matter involvement by multiple sclerosis spinal cord lesions
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DOI：
10.1016/j.msard.2012.09.005
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发表时间：
2013-04-01
影响因子：
4
通讯作者：
Miller, D. H.
中科院分区：
文献类型：
--
作者：
Kearney, H.;Miszkiel, K. A.;Miller, D. H.
目的：脊髓病理学是多发性硬化症（MS）残疾的主要原因，病理学研究显示白色物质（WM）束和中央灰质（GM）中的多灶性脱髓鞘病变。通过体内MRI更好地定位脊髓病变可能有助于了解MS中脊髓病理的结构-功能影响。方法：对15例MS患者和1例临床孤立综合征的上颈脊髓进行了三特斯拉MRI。采集轴向3D梯度回波快场回波（3D-FFE）和相敏反转恢复序列（3D-PSIR）。两名阅片人审查图像以检测和分类病变：仅WM、混合WM-GM或仅GM。结果：共发现51个病灶，其中混合型32个（63个），单纯型19个（37个），无单纯型。大多数发生在LC（n=30，59），其次是PC（n=18，35）和AC（n=3，6）。平均病变面积：AC 4.3 mm（2），LC 8.5 mm（2），PC 11.3 mm（2），分别对应于平均脊髓面积的6.1、12和16.1。平均病变长度：结论：虽然脊髓病变能很好地显示WM束受累，但中央灰质受累不太清楚。注意到脊髓病理学在MS中的重要作用，需要进一步的工作来更好地描述脊髓病变的体内成像。(C)2012 Elsevier B. V.保留所有权利。
Objectives: Spinal cord pathology is a major cause of disability in multiple sclerosis (MS) and pathology studies show multifocal demyelinating lesions in white matter (WM) tracts and central grey matter (GM). Better localisation of cord lesions by in vivo MRI may help to understand the structural-functional effects of spinal cord pathology in MS.Methods: Three-Tesla MRI was performed on upper cervical cord in 15 MS patients and one clinically isolated syndrome. Axial 3D gradient-echo fast field echo (3D-FFE) and phase sensitive inversion recovery sequences (3D-PSIR) were acquired. Two readers reviewed images to detect and classify lesions: WM-only, mixed WM-GM or GM-only. Location of the WM component was classified: anterior (AC), lateral (LC) or posterior (PC) column.Results: Fifty one lesions were identified: 32 (63) mixed WM-GM, 19 (37) WM-only, no GM-only. Most were in LC (n=30, 59), followed by PC (n=18, 35) and AC (n=3, 6). Mean lesion areas: AC 4.3 mm(2), LC 8.5 mm(2), PC 11.3 mm(2), corresponding to 6.1, 12 and 16.1 of mean cord area, respectively. Mean lesion lengths: 18.3 mm in AC, LC 17.6 mm and PC 24.8 mm.Conclusions: While there was good depiction of WM tract involvement by cord lesions, involvement of central grey matter was not as clear. Noting the important effects of spinal cord pathology in MS, further work to better depict cord lesions by in vivo imaging is warranted. (C) 2012 Elsevier B.V. All rights reserved.