Filippi M, Rocca M A, Moiola L, Martinelli V, Ghezzi A, Capra R, Salvi F, Comi G
Department of Neuroscience, Scientific Institute Ospedale San Raffaele, University of Milan, Italy.
Neurology. 1999 Nov 10;53(8):1705-10. doi: 10.1212/wnl.53.8.1705.
To assess MRI and magnetization transfer (MT) imaging changes in the brain and cervical cord from patients with Devic's neuromyelitis optica (DNO), and to compare them with those from patients with MS.
In MS, MT imaging detects changes within the normal-appearing brain tissue (NABT). MS lesions in the cord usually are isointense on T1-weighted images. No study has investigated these two aspects in patients with DNO.
The authors obtained dual echo, fast fluid-attenuated inversion recovery, T1-weighted, and MT scans of the brain from 8 DNO patients, 10 MS patients, and 9 healthy volunteers. T2-weighted, short-tau inversion recovery, T1-weighted, and MT scans of the cervical cord also were obtained. The authors identified lesions visible on the different scans and quantified the volumes for those in the brain. MT ratio (MTR) histogram analysis of the NABT and of the entire cervical cord also was performed.
No brain abnormalities were found on the T2-weighted scans from healthy volunteers and from seven DNO patients. No significant difference was found for any of the NABT-MTR histogram metrics between DNO patients and controls, whereas MS patients had a significantly lower histogram average MTR and peak height. No abnormalities were seen on any of the scans of the cervical cord from healthy volunteers. All DNO patients had a single lesion longer than two vertebral segments. Five of them were hypointense on T1-weighted scans. The authors identified 24 cord lesions from MS patients: 22 were shorter than two vertebral segments and none was hypointense. There was no difference in cervical cord MTR histogram metrics between DNO and MS patients.
This study demonstrates that patients with Devic's neuromyelitis optica (DNO) and MS have different imaging characteristics of the brain and cervical cord. This provides further evidence that DNO is a clinical entity separate from MS.
评估视神经脊髓炎谱系疾病（DNO）患者脑和颈髓的磁共振成像（MRI）及磁化传递（MT）成像变化，并与多发性硬化（MS）患者的这些变化进行比较。
在MS中，MT成像可检测到正常外观脑组织（NABT）内的变化。脊髓中的MS病灶在T1加权图像上通常呈等信号。尚无研究调查DNO患者的这两个方面。
作者对8例DNO患者、10例MS患者和9名健康志愿者进行了脑部的双回波、快速液体衰减反转恢复、T1加权和MT扫描。还获取了颈髓的T2加权、短tau反转恢复、T1加权和MT扫描。作者识别出不同扫描上可见的病灶，并对脑内病灶的体积进行了量化。还对NABT和整个颈髓进行了MT比率（MTR）直方图分析。
健康志愿者和7例DNO患者的T2加权扫描未发现脑部异常。DNO患者与对照组之间的任何NABT-MTR直方图指标均无显著差异，而MS患者的直方图平均MTR和峰值高度显著较低。健康志愿者的颈髓扫描均未发现异常。所有DNO患者均有一个长度超过两个椎体节段的单一病灶。其中5个在T1加权扫描上呈低信号。作者从MS患者中识别出24个脊髓病灶：22个短于两个椎体节段，且无低信号病灶。DNO患者和MS患者的颈髓MTR直方图指标无差异。
本研究表明，视神经脊髓炎谱系疾病（DNO）患者和MS患者在脑和颈髓的成像特征不同。这进一步证明DNO是一种与MS不同的临床实体。
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