Cucurella M G, Rovira A, Río J, Pedraza S, Tintoré M M, Montalbán X, Alonso J
Unitat de Ressonància Magnètica, Centre Vall d'Hebron, Institut de Diagnòstic per la Imatge, Pg. Vall d'Hebron 119-129, 08035 Barcelona, Spain.
NMR Biomed. 2000 Apr;13(2):57-63. doi: 10.1002/(sici)1099-1492(200004)13:2<57::aid-nbm609>3.0.co;2-5.
The objective of this study was to characterize and compare the proton magnetic resonance spectrum of a voxel, containing lesions or normal-appearing white matter (NAWM), in primary-progressive (PP) and secondary-progressive (SP) multiple sclerosis (MS) patients. Single-voxel proton magnetic resonance spectroscopy and magnetic resonance imaging were performed in 35 MS patients (17 PP and 18 SP) and 17 controls. Spectra from an 8 ml voxel located in the parieto-occipital region were obtained with a spin-echo pulse sequence (1600 ms/135 ms/256, TR/TE/acquisitions). Resonance areas due to N-acetylaspartate (NAA), creatine/phosphocreatine (Cr) and choline compounds (Cho) were determined, and results expressed in terms of area in arbitrary units or as metabolite ratios. With respect to the control group, there were significant reductions in NAA and NAA/Cho ratio in the PP-lesion, SP-lesion, PP-NAWM and SP-NAWM groups. There were no significant differences between the PP-NAWM and SP-NAWM groups. These results support the existence of metabolic changes in the white matter of PP and SP patients and suggest that there is neuronal damage and/or loss in both clinical courses. Finally, characterization of the parieto-occipital region showed no significant differences in the spectral pattern of NAWM between PP and SP clinical courses of MS.
本研究的目的是对原发性进展型（PP）和继发性进展型（SP）多发性硬化症（MS）患者中包含病灶或外观正常白质（NAWM）的体素的质子磁共振波谱进行表征和比较。对35例MS患者（17例PP和18例SP）和17名对照者进行了单体素质子磁共振波谱和磁共振成像检查。使用自旋回波脉冲序列（1600 ms/135 ms/256，TR/TE/采集次数）从位于顶枕区的一个8 ml体素中获取波谱。测定了由N-乙酰天门冬氨酸（NAA）、肌酸/磷酸肌酸（Cr）和胆碱化合物（Cho）引起的共振面积，结果以任意单位的面积或代谢物比率表示。与对照组相比，PP病灶组、SP病灶组、PP-NAWM组和SP-NAWM组的NAA和NAA/Cho比率均显著降低。PP-NAWM组和SP-NAWM组之间无显著差异。这些结果支持PP和SP患者白质中存在代谢变化，并表明在这两种临床病程中均存在神经元损伤和/或丢失。最后，对顶枕区的表征显示，在MS的PP和SP临床病程之间，NAWM的波谱模式无显著差异。
