Hecht Martin J, Fellner F, Fellner C, Hilz M J, Neundörfer B, Heuss D
Department of Neurology, Friedrich-Alexander-University of Erlangen-Nuremberg, Schwabachanlage 6, D-91054 Erlangen, Germany.
J Neurol Sci. 2002 Jul 15;199(1-2):59-65. doi: 10.1016/s0022-510x(02)00104-1.
In amyotrophic lateral sclerosis (ALS) patients, hyperintense signals at the subcortical precentral gyrus in brain fluid attenuated inversion recovery (FLAIR) MR images have been found more frequently than in controls. Quantitative analysis has revealed a significant increase of the FLAIR-magnetic resonance imaging (MRI) signal at the subcortical precentral gyrus of ALS patients compared to healthy controls. In addition, hypointense signals at the rim of the precentral gyrus in FLAIR and T2-weighted images have been shown in ALS patients. In 17 ALS patients, we evaluated hyperintense signals in T2-, T1-, proton density-weighted and FLAIR MR images, and hypointense signals in T2-weighted and FLAIR images 15.7+/-3.0 months after the initial examination by visual scoring. In FLAIR images, a quantitative analysis was added. The visual scores of hyperintense signals along the corticospinal tract did not change significantly in all sequences. However, the quantitative evaluation of FLAIR images revealed a significant increase of the signal intensity at the subcortical precentral gyrus (p<0.005). In addition, the frequency of the visually evaluated hypointense signals at the precentral gyrus increased significantly (p<0.05). The change of MR results did not correlate with the change of clinical parameters. In ALS patients, the increase of the quantified MRI signal at the subcortical precentral gyrus in FLAIR images and the increase of hypointense signals at the rim of the precentral gyrus corroborate the hypothesis that these signals are related to the upper motor neuron degeneration in ALS. Their specificity and clinical relevance have to be clarified further.
在肌萎缩侧索硬化症（ALS）患者中，与对照组相比，在脑积液衰减反转恢复（FLAIR）磁共振成像（MR）图像上，皮质下中央前回出现高信号的情况更为常见。定量分析显示，与健康对照组相比，ALS患者皮质下中央前回的FLAIR磁共振成像（MRI）信号显著增加。此外，在ALS患者的FLAIR和T2加权图像中，中央前回边缘出现了低信号。在17例ALS患者中，我们在初次检查后15.7±3.0个月，通过视觉评分评估了T2、T1、质子密度加权和FLAIR MR图像中的高信号，以及T2加权和FLAIR图像中的低信号。在FLAIR图像中，还进行了定量分析。在所有序列中，沿皮质脊髓束的高信号视觉评分没有显著变化。然而，FLAIR图像的定量评估显示，皮质下中央前回的信号强度显著增加（p<0.005）。此外，中央前回视觉评估的低信号频率显著增加（p<0.05）。MR结果的变化与临床参数的变化无关。在ALS患者中，FLAIR图像中皮质下中央前回定量MRI信号的增加以及中央前回边缘低信号的增加，证实了这些信号与ALS上运动神经元变性有关的假设。它们的特异性和临床相关性还需要进一步阐明。
