Griffin Colette M, Chard Declan T, Parker Geoff J M, Barker Gareth J, Thompson Alan J, Miller David H
NMR Research Unit, Institute of Neurology, London, UK.
J Neurol. 2002 Feb;249(2):193-9. doi: 10.1007/pl00007864.
In multiple sclerosis (MS), pathological changes have been found both in macroscopic lesions and normal appearing tissue. Magnetisation transfer ratio (MTR) and T1 relaxation time are abnormal in normal appearing tissues in established MS. This study used these MR techniques in early MS to study normal appearing tissues and lesions. The purpose was to determine whether abnormalities are already detectable in normal appearing tissues in early MS, and if so how they correlate with lesion characteristics.
Twenty two patients with early relapsing remitting (RR) MS (median disease duration 2 years, range 7 months-3 years) and 11 age-matched controls were studied. MTR and T1 relaxation times were measured in 9 regions of normal appearing white matter (NAWM) and 7 of normal appearing grey matter (NAGM). Gadolinium enhancing, T1-hypointense and T2 lesion loads were measured in all patients.
When all regions were combined, there was a significant difference between patient and control NAWM for both T1 and MTR; T1 was abnormal in 6/9 and MTR in 3/9 NAWM regions. Global assessment of NAGM revealed a significant difference between patients and controls for Ti but not for MTR; T1 was significantly abnormal only in frontal NAGM. There was no significant correlation between NAWM T1 or MTR and any of the lesion load measurements.
This study reveals quantitative MR abnormalities in both NAWM and NAGM in early RR MS, with more extensive changes in the former. The lack of correlation between NAWM and lesion abnormalities suggests that they have developed by at least partly independent mechanisms. T1 may be more sensitive than MTR in detecting subtle pathological changes in NAWM and NAGM.
在多发性硬化症（MS）中，已在宏观病变和外观正常的组织中均发现了病理变化。在已确诊的MS患者的外观正常组织中，磁化传递率（MTR）和T1弛豫时间均异常。本研究在早期MS中使用这些磁共振技术来研究外观正常的组织和病变。目的是确定在早期MS的外观正常组织中是否已可检测到异常，若如此，这些异常与病变特征之间的相关性如何。
对22例早期复发缓解型（RR）MS患者（疾病持续时间中位数为2年，范围7个月至3年）和11名年龄匹配的对照者进行了研究。在9个外观正常的白质（NAWM）区域和7个外观正常的灰质（NAGM）区域测量了MTR和T1弛豫时间。对所有患者测量了钆增强、T1低信号和T2病变负荷。
当所有区域合并时，患者和对照者的NAWM在T1和MTR方面均存在显著差异；在6/9的NAWM区域中T1异常，在3/9的NAWM区域中MTR异常。对NAGM的整体评估显示，患者和对照者在T1方面存在显著差异，但在MTR方面无显著差异；仅额叶NAGM中的T1显著异常。NAWM的T1或MTR与任何病变负荷测量值之间均无显著相关性。
本研究揭示了早期RR MS患者的NAWM和NAGM中均存在定量磁共振异常，前者的变化更为广泛。NAWM与病变异常之间缺乏相关性表明它们至少部分是通过独立机制发展而来的。在检测NAWM和NAGM中的细微病理变化方面，T1可能比MTR更敏感。
