Agosta F, Benedetti B, Rocca M A, Valsasina P, Rovaris M, Comi G, Filippi M
Neuroimaging Research Unit, Scientific Institute and University Ospedale San Raffaele, Milan, Italy.
Neurology. 2005 Feb 22;64(4):631-5. doi: 10.1212/01.WNL.0000151852.15294.CB.
To investigate the extent and severity of cervical cord damage using diffusion tensor MRI (DT-MRI) and histogram analysis in patients with primary progressive MS (PPMS).
Diffusion-weighted sensitivity-encoded (SENSE) echoplanar images of the cervical cord and brain dual-echo and diffusion-weighted scans were acquired from 24 patients with PPMS and 13 healthy controls. Cord and brain mean diffusivity and fractional anisotropy histograms were produced. An analysis of variance model, adjusting for cord volume, was used to compare cord DT-MRI parameters from controls and patients.
Compared to healthy controls, PPMS patients had reduced cervical cord cross-sectional area and average cord fractional anisotropy (p = 0.007), and increased cord mean diffusivity (p = 0.024). No correlations were found between DT-MRI metrics of the cord and quantities obtained from conventional and DT-MRI of the brain.
DT-MRI of the cervical cord can quantify the extent of diffuse cord pathology in patients with PPMS. Such cord diffusivity changes in patients with PPMS are likely to reflect irreversible axonal injury and reactive gliosis and seem to be independent of brain damage.
利用扩散张量磁共振成像（DT-MRI）和直方图分析研究原发性进展型多发性硬化症（PPMS）患者颈髓损伤的程度和严重性。
对24例PPMS患者和13名健康对照者进行颈髓和脑部的扩散加权敏感编码（SENSE）回波平面成像、双回波及扩散加权扫描。生成颈髓和脑部的平均扩散率及各向异性分数直方图。采用校正颈髓体积的方差分析模型，比较对照组和患者组的颈髓DT-MRI参数。
与健康对照者相比，PPMS患者的颈髓横截面积和平均颈髓各向异性分数降低（p = 0.007），颈髓平均扩散率升高（p = 0.024）。未发现颈髓DT-MRI指标与脑部传统及DT-MRI所获数值之间存在相关性。
颈髓DT-MRI能够量化PPMS患者弥漫性脊髓病变的程度。PPMS患者的这种脊髓扩散率变化可能反映了不可逆的轴突损伤和反应性胶质增生，且似乎与脑损伤无关。
