Kapeller P, Ropele S, Enzinger C, Lahousen T, Strasser-Fuchs S, Schmidt R, Fazekas F
Dept. of Neurology, University of Graz, Austria.
J Neurol. 2005 Oct;252(10):1229-34. doi: 10.1007/s00415-005-0847-3. Epub 2005 May 20.
Multiple sclerosis (MS) plaques and age related white matter lesions (WML) are of similar morphological appearance on T2 weighted MRI. Therefore their differentiation is sometimes crucial. Proton magnetic resonance spectroscopy ((1)H-MRS) adds metabolic information to conventional imaging and may help to distinguish inflammatory MS plaques from vascular related WML. This study was performed to evaluate the metabolite pattern in MS plaques and WML. 15 MS patients, 14 elderly individuals with WML and 16 controls were investigated by conventional MRI and short echo quantitative (1)H-MRS (TE: 30ms, TR: 3000ms). The mean metabolite concentrations in normal control white matter (NCWM), MS plaques and WML were: t-NAA: 8.96 mmol/l (SD: 0.93) vs 6.79 mmol/l (SD: 1.99) vs 7.18 mmol/l (SD: 1.41); Cho:1.66 mmol/l (SD: 0.4) vs 1.49 mmol/l (SD: 0.45) vs 1.46 mmol/l (SD: 0.34); PCr:5.64 mmol/l (SD: 0.83) vs 4.9mmol/l (SD: 1.3) vs 4.95 mmol/l (SD: 0.86); myo-Ins: 4.57 mmol/l (SD:1.05) vs 6.34 mmol/l (SD: 2.03) vs 4.5 mmol/l (SD: 0.96). t-NAA reduction in MS plaques and WML was significant compared with controls (p <or= 0.001). MS plaques showed significantly elevated myo- Ins concentrations compared with controls (p = 0.002) and to WML (p = 0.003). In summary MS plaques and WML show a decrease in their t-NAA concentrations compared with controls. Elevated concentrations of myo-Ins in MS plaques but not in WML makes this metabolite of special interest for their differentiation.
多发性硬化症（MS）斑块与年龄相关的白质病变（WML）在T2加权磁共振成像（MRI）上具有相似的形态学表现。因此，它们的鉴别有时至关重要。质子磁共振波谱（（1）H-MRS）为传统成像增添了代谢信息，可能有助于区分炎性MS斑块与血管相关的WML。本研究旨在评估MS斑块和WML中的代谢物模式。通过传统MRI和短回波定量（1）H-MRS（TE：30ms，TR：3000ms）对15例MS患者、14例有WML的老年人和16例对照者进行了研究。正常对照白质（NCWM）、MS斑块和WML中的平均代谢物浓度分别为：总N-乙酰天门冬氨酸（t-NAA）：8.96 mmol/l（标准差：0.93）对比6.79 mmol/l（标准差：1.99）对比7.18 mmol/l（标准差：1.41）；胆碱（Cho）：1.66 mmol/l（标准差：0.4）对比1.49 mmol/l（标准差：0.45）对比1.46 mmol/l（标准差：0.34）；磷酸肌酸（PCr）：5.64 mmol/l（标准差：0.83）对比4.9 mmol/l（标准差：1.3）对比4.95 mmol/l（标准差：0.86）；肌醇（myo-Ins）：4.57 mmol/l（标准差：1.05）对比6.34 mmol/l（标准差：2.03）对比4.5 mmol/l（标准差：0.96）。与对照组相比，MS斑块和WML中的t-NAA降低具有显著性（p≤0.001）。与对照组相比（p = 0.002）以及与WML相比（p = 0.003），MS斑块显示出肌醇浓度显著升高。总之，与对照组相比，MS斑块和WML的t-NAA浓度降低。MS斑块中肌醇浓度升高而WML中未升高，使得这种代谢物对于它们的鉴别具有特殊意义。
