Schmierer K, Scaravilli F, Barker G J, Gordon R, MacManus D G, Miller D H
Department of Neuroinflammation, MS NMR Research Unit, Division of Neuropathology, Institute of Neurology, University College London, London, UK.
Neuropathol Appl Neurobiol. 2003 Dec;29(6):596-601. doi: 10.1046/j.0305-1846.2003.00497.x.
A number of groups have examined the pathological substrate of signal changes on magnetic resonance imaging (MRI) in post-mortem (PM) brain of patients with multiple sclerosis (MS). Such studies will benefit from using a standardized method to reliably co-register regions of interest on MRI and tissue specimens. We investigated the usefulness of a stereotactic navigation system for this purpose. We also addressed the sensitivity of different standard MRI sequences with regard to lesion conspicuity in PM MS brain. Post-mortem brains of eight patients with MS were studied. Formalin-fixed coronal slices were placed in the head frame of a stereotactic system. Proton density-, T2-weighted and fast fluid-attenuated inversion recovery (FLAIR) scans were obtained and visually matched with scans that had been previously obtained on the same, but fresh, specimens. Guided by the stereotactic target points, the dissection of the fixed specimens was performed. After processing the blocks for embedding in paraffin, sections were stained with haematoxylin-eosin and Luxol fast blue. T2-weighted MRI of fixed brain revealed 24 areas suspected to be MS lesions, all of which were confirmed histologically. Three of these lesions were not visible on macroscopic inspection. There were 14 additional hyperintensities on T2-weighted or FLAIR MRI of the fresh specimens, five of which did not correlate to MS lesions histologically. Stereotactic navigation is a useful approach to co-register MRI and histopathology in PM brain of MS patients and may improve the precision of MRI-guided sampling of tissue specimens. Standard T2-weighted MRI appeared to be the single most useful approach for lesion detection in fresh and fixed specimens.
多个研究小组已对多发性硬化症（MS）患者死后（PM）大脑磁共振成像（MRI）信号变化的病理基础进行了研究。此类研究将受益于使用标准化方法，以便在MRI和组织标本上可靠地共同配准感兴趣区域。我们为此目的研究了立体定向导航系统的实用性。我们还探讨了不同标准MRI序列对PM MS脑病变显见度的敏感性。对8例MS患者的死后大脑进行了研究。将福尔马林固定的冠状切片置于立体定向系统的头架中。获得质子密度加权、T2加权和快速液体衰减反转恢复（FLAIR）扫描，并将其与之前在相同但新鲜的标本上获得的扫描进行视觉匹配。在立体定向靶点的引导下，对固定标本进行解剖。将组织块处理后嵌入石蜡，切片用苏木精-伊红和卢氏固蓝染色。固定脑的T2加权MRI显示24个疑似MS病变区域，所有这些区域均经组织学证实。其中3个病变在肉眼检查中不可见。新鲜标本的T2加权或FLAIR MRI上还有14个高信号，其中5个在组织学上与MS病变无关。立体定向导航是在MS患者PM脑中共同配准MRI和组织病理学的一种有用方法，可能会提高MRI引导下组织标本采样的精度。标准T2加权MRI似乎是在新鲜和固定标本中检测病变的最有用的单一方法。
