Khalil M, Enzinger C, Langkammer C, Tscherner M, Wallner-Blazek M, Jehna M, Ropele S, Fuchs S, Fazekas F
Department of Neurology and Department of Radiology (Division of Neuroradiology), Medical University of Graz, Graz, Austria.
Mult Scler. 2009 Sep;15(9):1048-54. doi: 10.1177/1352458509106609. Epub 2009 Jun 25.
Increased iron deposition has been implicated in the pathophysiology of multiple sclerosis (MS), based on visual analysis of signal reduction on T(2)-weighted images. R(2)* relaxometry allows to assess brain iron accumulation quantitatively.
To investigate regional brain iron deposition in patients with a clinically isolated syndrome (CIS) or relapsing-remitting MS (RRMS) and its associations with demographical, clinical, and conventional magnetic resonance imaging (MRI) parameters.
We studied 69 patients (CIS, n = 32; RRMS, n = 37) with 3T MRI and analyzed regional R(2)* relaxation rates and their correlations with age, disease duration, disability, T(2) lesion load, and normalized brain volumes.
Basal ganglia R(2)* relaxation rates increased in parallel with age (r = 0.3-0.6; P < 0.01) and were significantly higher in RRMS than in CIS (P < 0.05). Using multivariate linear regression analysis, the rate of putaminal iron deposition was independently predicted by the patients' age, disease duration, and gray matter atrophy.
Quantitative assessment by R(2)* relaxometry suggests increased iron deposition in the basal ganglia of MS patients, which is associated with disease duration and brain atrophy. This technique together with long-term follow-up thus appears suited to clarify whether regional iron accumulation contributes to MS morbidity or merely reflects an epiphenomenon.
基于对T(2)加权图像信号降低的视觉分析，铁沉积增加与多发性硬化症（MS）的病理生理学有关。R(2)*弛豫测量法可定量评估脑铁积累情况。
研究临床孤立综合征（CIS）或复发缓解型多发性硬化症（RRMS）患者的脑局部铁沉积情况及其与人口统计学、临床和传统磁共振成像（MRI）参数的关联。
我们对69例患者（CIS，n = 32；RRMS，n = 37）进行了3T MRI检查，并分析了局部R(2)*弛豫率及其与年龄、病程、残疾程度、T(2)病变负荷和标准化脑体积的相关性。
基底节区的R(2)*弛豫率随年龄增长而升高（r = 0.3 - 0.6；P < 0.01），且RRMS患者显著高于CIS患者（P < 0.05）。采用多元线性回归分析，壳核铁沉积率可由患者年龄、病程和灰质萎缩独立预测。
R(2)*弛豫测量法的定量评估表明MS患者基底节区铁沉积增加，这与病程和脑萎缩有关。因此，这项技术结合长期随访似乎适合阐明局部铁积累是导致MS发病还是仅仅反映一种附带现象。
