Rovaris M, Bozzali M, Santuccio G, Iannucci G, Sormani M P, Colombo B, Comi G, Filippi M
Neuroimaging Research Unit, Department of Neuroscience, Scientific Institute Ospedale San Raffaele, University of Milan, Via Olgettina 60, 20132 Milan, Italy.
J Neurol Neurosurg Psychiatry. 2000 Dec;69(6):723-7. doi: 10.1136/jnnp.69.6.723.
To assess (a) the correlations between magnetisation transfer ratio (MTR) histogram derived measures of the brain and the cervical cord from patients with different multiple sclerosis phenotypes and (b) the correlation between these metrics and clinical disability. Magnetisation transfer imaging is sensitive to the most destructive aspects of multiple sclerosis pathology. Magnetisation transfer ratio histogram analysis encompasses the macroscopic and the microscopic lesion burdens.
Seventy seven patients with multiple sclerosis were studied (40 relapsing-remitting (RR), 28 secondary progressive (SP), and nine primary progressive (PP)). For the brain, we obtained dual echo, T1 weighted, and gradient echo (GE) scans (with and without an MT saturation pulse). For the cervical cord, fast short tau inversion recovery (STIR) and GE scans (with and without an MT saturation pulse) were obtained. Brain T2 and T1 weighted lesion volumes (LVs) were measured. The number and length of cord lesions on fast STIR scans were assessed. Magnetisation transfer ratio maps were created from GE images and MTR histograms of the entire brain and cervical cord were obtained.
Brain T1 LV, and number and size of cord lesions were significantly higher and brain MTR histogram peak location was significantly lower in patients with SPMS than those with RRMS or PPMS. Cord MTR histogram peak location was also significantly lower in patients with SPMS than in those with RRMS. The univariate correlations between MTR histogram derived metrics obtained from the brain and the cervical cord were all non-significant, with the exception of that between average brain MTR and cord MTR histogram peak location. On a multivariable analysis, both increasing brain T2 LV and decreasing cord MTR histogram peak location values were significantly associated with a higher probability for patients to have SPMS or to have locomotor disability.
This study shows that the extent and severity of tissue damage in the brain and cervical cord are both relevant to determine disability in multiple sclerosis and that the assessment of brain and cord pathology provides complementary information.
评估（a）不同多发性硬化表型患者脑和颈髓的磁化传递率（MTR）直方图衍生指标之间的相关性，以及（b）这些指标与临床残疾之间的相关性。磁化传递成像对多发性硬化病理最具破坏性的方面敏感。MTR直方图分析涵盖宏观和微观病变负荷。
对77例多发性硬化患者进行研究（40例复发缓解型（RR）、28例继发进展型（SP）和9例原发进展型（PP））。对于脑部，我们获取了双回波、T1加权和梯度回波（GE）扫描（有和没有MT饱和脉冲）。对于颈髓，获取了快速短tau反转恢复（STIR）和GE扫描（有和没有MT饱和脉冲）。测量脑部T2和T1加权病变体积（LVs）。评估快速STIR扫描上脊髓病变的数量和长度。从GE图像创建MTR图，并获取整个脑和颈髓的MTR直方图。
与RRMS或PPMS患者相比，SPMS患者的脑T1 LV、脊髓病变的数量和大小显著更高，脑MTR直方图峰值位置显著更低。与RRMS患者相比，SPMS患者的脊髓MTR直方图峰值位置也显著更低。从脑和颈髓获得的MTR直方图衍生指标之间的单变量相关性均无统计学意义，但平均脑MTR与脊髓MTR直方图峰值位置之间的相关性除外。在多变量分析中，脑T2 LV增加和脊髓MTR直方图峰值位置值降低均与患者患SPMS或有运动障碍的较高概率显著相关。
本研究表明，脑和颈髓组织损伤的程度和严重程度均与确定多发性硬化的残疾情况相关，并且对脑和脊髓病理的评估提供了互补信息。
