Kitamura Kaeko, Nakayama Keiko, Kosaka Satoru, Yamada Eiji, Shimada Hiroyuki, Miki Takami, Inoue Yuichi
Department of Radiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, abeno-ku, Osaka 545-8585, Japan.
Neuroradiology. 2008 Apr;50(4):285-92. doi: 10.1007/s00234-007-0351-9. Epub 2008 Jan 3.
We sought to determine whether diffusion-tensor imaging (DTI) can detect in vivo axonal damage in the corticopontocerebellar pathway of patients with adult-onset ataxic neurodegenerative disease.
Conventional MRI and DTI were performed on 18 patients with adult-onset ataxic neurodegenerative disease and 28 age-matched control subjects. Fractional anisotropy (FA) and the mean diffusivity (MD) were measured in the ventral, central, and dorsal pons, middle cerebellar peduncle (MCP) and internal capsule to evaluate corticopontocerebellar projection. Changes in FA and MD values were compared between patients and controls. Clinical disability was assessed according to the International Cooperative Ataxia Rating Scale (ICARS). The relationship between DTI measurements and ICARS was studied. Follow-up MRI was performed in five patients approximately 1 year later.
FA values were significantly lower in the ventral and central portions of the pons, MCP, and internal capsules than in these areas in control subjects (P < 0.05) with the lower FA values correlating with poorer ICARS (r > -0.57, P < 0.05). MD values were elevated in these areas, but the differences were smaller than for the FA values. No relationship was observed between the MD and ICARS. In the five patients who underwent the follow-up study, there were significant decreases between the initial study and the follow-up DTI study for FA in the MCP and internal capsule (P < 0.05).
DTI can demonstrate a degenerated corticopontocerebellar pathway in patients, and FA values can be correlated with ataxia severity. DTI may be a clinically useful tool as a quantitative surrogate marker for monitoring disease progression.
我们试图确定弥散张量成像（DTI）是否能够检测成年起病的共济失调性神经退行性疾病患者皮质脑桥小脑通路的体内轴突损伤。
对18例成年起病的共济失调性神经退行性疾病患者和28例年龄匹配的对照者进行了常规MRI和DTI检查。测量脑桥腹侧、中央和背侧、小脑中脚（MCP）和内囊的分数各向异性（FA）和平均扩散率（MD），以评估皮质脑桥小脑投射。比较患者和对照者之间FA和MD值的变化。根据国际合作共济失调评定量表（ICARS）评估临床残疾情况。研究DTI测量值与ICARS之间的关系。约1年后对5例患者进行了随访MRI检查。
与对照组相比，患者脑桥腹侧和中央部分、MCP和内囊的FA值显著降低（P < 0.05），较低的FA值与较差的ICARS相关（r > -0.57，P < 0.05）。这些区域的MD值升高，但差异小于FA值。未观察到MD与ICARS之间的关系。在接受随访研究的5例患者中，MCP和内囊的FA在初始研究和随访DTI研究之间有显著下降（P < 0.05）。
DTI能够显示患者退化的皮质脑桥小脑通路，且FA值与共济失调严重程度相关。DTI可能是一种临床上有用的工具，作为监测疾病进展的定量替代标志物。
