Department of Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada.
AJNR Am J Neuroradiol. 2011 Jan;32(1):199-203. doi: 10.3174/ajnr.A2224. Epub 2010 Aug 26.
We evaluated the DTI changes in the deep gray nuclei and dorsal brain stem, which demonstrated abnormal T2 and/or diffusion signal intensity, in 6 patients with infantile spasm treated with vigabatrin compared with 6 age-matched controls. Regions of interest were placed in the globi pallidi, thalami, and dorsal brain stem; FA, trace, D(‖), and D(⊥) were measured. Patients on vigabatrin had significantly lower FA in both globi pallidi (P = .01) and the dorsal brain stem (P < .01), significantly lower trace in both globi pallidi (P = .01) and the thalami (P = .02 and .01 for right and left, respectively), and significantly lower D(‖) in both globi pallidi (P ≤ .01), the thalami (P < .01), and the dorsal brain stem (P = .03). There were no significant differences in D(⊥) of the globi pallidi, thalami, or dorsal brain stem in patients compared with controls. The findings suggest that axonal changes play a greater role in the observed abnormal signal intensity, with lesser contribution from myelin changes.
我们评估了 6 例接受氨己烯酸治疗的婴儿痉挛症患者和 6 例年龄匹配的对照组的深部灰质核和背侧脑干的 DTI 变化，这些部位表现出异常的 T2 和/或弥散信号强度。感兴趣区位于苍白球、丘脑和背侧脑干；测量 FA、trace、D(‖)和 D(⊥)。氨己烯酸治疗的患者双侧苍白球（P =.01）和背侧脑干（P <.01）的 FA 值显著降低，双侧苍白球（P =.01）和丘脑（右侧和左侧分别为 P =.02 和.01）的 trace 值显著降低，双侧苍白球（P ≤.01）、丘脑（P <.01）和背侧脑干（P =.03）的 D(‖)值显著降低。与对照组相比，患者的苍白球、丘脑或背侧脑干的 D(⊥)值无显著差异。这些发现表明，轴突变化在观察到的异常信号强度中起更大的作用，而少突胶质细胞变化的贡献较小。
