Vavasour I M, Laule C, Li D K B, Oger J, Moore G R W, Traboulsee A, MacKay A L
Department of Radiology, University of British Columbia, Vancouver, BC, Canada.
J Neurol Sci. 2009 Jan 15;276(1-2):49-53. doi: 10.1016/j.jns.2008.08.022. Epub 2008 Sep 25.
Multiple sclerosis (MS) is characterised by focal areas that undergo cycles of demyelination and remyelination. Although conventional magnetic resonance imaging is very effective in localising areas of damage, these techniques are not pathology specific. A newer technique, T(2) relaxation, can separate water from brain into three compartments: (1) a long T(2) component (>2 s) arising from CSF, (2) an intermediate T(2) component (80 ms) attributed to intra- and extra-cellular water and (3) a short T(2) component (20 ms) assigned to water trapped in between the myelin bilayers (termed myelin water). Histological evidence shows that myelin water is a specific marker of myelination. The goal of this work was to follow changes in total water content (WC) and myelin water fraction (MWF) in evolving MS lesions over one year. Multi-echo T(2) relaxation data was collected and used to measure water content and myelin water fraction from three new MS lesions in two patients. WC increased in the three large (>1 cm(3)) lesions at lesion appearance and remained elevated in the central core. Two lesions showed low MWF in the core suggesting demyelination upon first appearance. At later time points, one lesion showed a decrease in volume of low MWF, reflecting remyelination whereas the volume of low MWF in the other lesion core remained constant. This work provides evidence that MWF and WC can monitor demyelination and remyelination in MS.
多发性硬化症(MS)的特征是存在经历脱髓鞘和再髓鞘化循环的局灶性区域。尽管传统的磁共振成像在定位损伤区域方面非常有效,但这些技术并非病理特异性的。一种更新的技术,即T(2)弛豫,可以将脑内的水分离为三个部分:(1)由脑脊液产生的长T(2)成分(>2 s),(2)归因于细胞内和细胞外水的中间T(2)成分(约80 ms),以及(3)分配给被困在髓鞘双层之间的水(称为髓鞘水)的短T(2)成分(约20 ms)。组织学证据表明,髓鞘水是髓鞘形成的特异性标志物。这项工作的目的是追踪一年中进展性MS病变的总含水量(WC)和髓鞘水分数(MWF)的变化。收集了多回波T(2)弛豫数据,并用于测量两名患者三个新MS病变的含水量和髓鞘水分数。在病变出现时,三个大(>1 cm(3))病变的WC增加,并在中央核心区域保持升高。两个病变在核心区域显示低MWF,表明首次出现时存在脱髓鞘。在随后的时间点,一个病变显示低MWF体积减少,反映了再髓鞘化,而另一个病变核心区域的低MWF体积保持不变。这项工作提供了证据,表明MWF和WC可以监测MS中的脱髓鞘和再髓鞘化。