丘脑在多发性硬化症中的受累情况：一项扩散加权磁共振成像研究。

Thalamic involvement in multiple sclerosis: a diffusion-weighted magnetic resonance imaging study.

作者信息

Fabiano Andrew J, Sharma Jitendra, Weinstock-Guttman Bianca, Munschauer Frederick E, Benedict Ralph H, Zivadinov Robert, Bakshi Rohit

机构信息

Buffalo Neuroimaging Analysis Center, Jacobs Neurological Institute, 100 High Street, Buffalo, NY 14203, USA.

出版信息

J Neuroimaging. 2003 Oct;13(4):307-14.

PMID:14569822

Abstract

BACKGROUND AND PURPOSE

Injury to deep gray matter structures in multiple sclerosis (MS) has been suggested by recent neuro-imaging and neuropathology studies. Diffusion-weighted magnetic resonance imaging (MRI) can assess tissue damage with greater sensitivity than conventional MRI. The authors' objective was to assess thalamic gray matter damage by diffusion-weighted imaging in MS patients.

METHODS

This was a retrospective study performed at a tertiary care, university-affiliated comprehensive MS center of 82 MS patients and 43 controls. The main outcome measures were thalamic apparent diffusion coefficients (ADCs), whole-brain atrophy (brain parenchymal fraction), fluid-attenuated inversion recovery (FLAIR) hypertense lesion volume, and clinical course.

RESULTS

ADCs in the left thalamus were higher in MS patients (0.741 +/- 0.044 x 10(-3) mm2/s) than controls (0.723 +/- 0.036 x 10(-3) mm2/s) (P = .027) and higher in secondary progressive MS patients (0.761 +/- 0.044 x 10(-3) mm2/s) than relapsing-remitting MS patients (0.735 +/- 0.032 x 10(-3) mm2/s) (P = .029). ADCs in the right thalamus were higher in secondary progressive MS patients (0.784 +/- 0.069 x 10(-3) mm2/s) than controls (0.757 +/- 0.038 x 10(-3) mm2/s) (P = .033). In the MS group, left thalamus ADCs correlated negatively with brain parenchymal fraction (r = -0.30, P = .008), total left hemispheric FLAIR lesion volume correlated with ADCs in the left (r = 0.35, P = .001) and right (r = 0.39, P < .001) thalami, and total right hemispheric FLAIR lesion volume correlated with ADCs in the left (r = 0.31, P = .006) and right thalami (r = 0.22, P = .048).

CONCLUSION

MS patients have increased water diffusion in the thalamus that is partly associated with clinical course, lesion load, and whole-brain atrophy. Both indirect and direct mechanisms of gray matter injury may play a role in the pathophysiology of MS.

摘要

背景与目的

近期神经影像学和神经病理学研究提示，多发性硬化（MS）患者深部灰质结构存在损伤。扩散加权磁共振成像（MRI）对组织损伤的评估比传统MRI更具敏感性。作者的目的是通过扩散加权成像评估MS患者丘脑灰质损伤情况。

方法

这是一项在一所大学附属三级综合MS中心进行的回顾性研究，纳入82例MS患者和43例对照。主要观察指标为丘脑表观扩散系数（ADC）、全脑萎缩（脑实质分数）、液体衰减反转恢复（FLAIR）高信号病变体积及临床病程。

结果

MS患者左侧丘脑的ADC值（0.741±0.044×10⁻³mm²/s）高于对照组（0.723±0.036×10⁻³mm²/s）（P = 0.027），继发进展型MS患者左侧丘脑的ADC值（与复发缓解型MS患者（0.735±0.032×10⁻³mm²/s）相比更高（0.761±0.044×10⁻³mm²/s）（P = 0.029）。继发进展型MS患者右侧丘脑的ADC值（0.784±0.0,69×10⁻³mm²/s）高于对照组（0.757±0.038×10⁻³mm²/s）（P = 0.033）。在MS组中，左侧丘脑ADC值与脑实质分数呈负相关（r = -0.30，P = 0.008），左侧半球FLAIR病变总体积与左侧（r = 0.35，P = 0.001）和右侧（r = 0.39，P < 0.001）丘脑的ADC值相关，右侧半球FLAIR病变总体积与左侧（r = 0.31，P = 0.006）和右侧丘脑（r = 0.22，P = 0.048）的ADC值相关。