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健康成年人和复发缓解型多发性硬化症患者胼胝体正常外观七个节段的扩散张量分数各向异性

Diffusion tensor fractional anisotropy of the normal-appearing seven segments of the corpus callosum in healthy adults and relapsing-remitting multiple sclerosis patients.

作者信息

Hasan Khader M, Gupta Rakesh K, Santos Rafael M, Wolinsky Jerry S, Narayana Ponnada A

机构信息

Department of Interventional and Diagnostic Imaging, University of Texas Medical School at Houston, Houston, Texas, USA.

出版信息

J Magn Reson Imaging. 2005 Jun;21(6):735-43. doi: 10.1002/jmri.20296.

Abstract

PURPOSE

To investigate the utility of whole-brain diffusion tensor imaging (DTI) in elucidating the pathogenesis of multiple sclerosis (MS) using the normal-appearing white matter (NAWM) of the corpus callosum (CC) as a marker of occult disease activity.

MATERIALS AND METHODS

A high signal-to-noise ratio (SNR) and optimized entire brain DTI data were acquired in 26 clinically-definite relapsing and remitting multiple sclerosis (RRMS) patients and 32 age-matched healthy adult controls. The fractional anisotropy (FA) values of seven functionally distinct regions in the normal-appearing CC were compared between patients and controls.

RESULTS

This study indicates that 1) there was a gender-independent FA heterogeneity of the functionally specialized CC segments in normal volunteers; 2) FA in the MS group was significantly decreased in the anterior (P=0.0039) and posterior (P=0.0018) midbody subdivisions of the CC, possibly due to a reduction of small-caliber axons; and 3) the FA of the genu of the CC was relatively intact in the MS patients compared to the healthy age-matched controls (P=0.644), while the splenium showed an insignificant trend of reduced FA values (P=0.248). The decrease in FA in any of the CC subdivisions did not correlate with disease duration (DD) or the expanded disability status scale (EDSS) score.

CONCLUSION

The preliminary results are consistent with published histopathology and clinical studies on MS, but not with some published DTI reports. This study provides insights into the pathogenesis of MS, and the role played by compromised axonal integrity in this disease.

摘要

目的

以胼胝体正常表现白质(NAWM)作为隐匿性疾病活动的标志物,探讨全脑弥散张量成像(DTI)在阐明多发性硬化症(MS)发病机制中的作用。

材料与方法

对26例临床确诊的复发缓解型多发性硬化症(RRMS)患者和32例年龄匹配的健康成人对照组进行了高信噪比(SNR)及优化的全脑DTI数据采集。比较了患者和对照组在正常表现的胼胝体中七个功能不同区域的分数各向异性(FA)值。

结果

本研究表明:1)正常志愿者中功能特化的胼胝体节段存在与性别无关的FA异质性;2)MS组胼胝体中部前(P = 0.0039)、后(P = 0.0018)亚区的FA显著降低,可能是由于小口径轴突减少所致;3)与年龄匹配的健康对照组相比,MS患者胼胝体膝部FA相对完整(P = 0.644),而压部FA值呈不显著的降低趋势(P = 0.248)。胼胝体任何亚区FA降低均与病程(DD)或扩展残疾状态量表(EDSS)评分无关。

结论

初步结果与已发表的关于MS病理组织学和临床研究一致,但与一些已发表的DTI报告不一致。本研究为MS发病机制以及轴突完整性受损在该疾病中的作用提供了见解。

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