Department of Radiology, Washington University, St. Louis, MO 63110, USA.
Brain. 2011 Dec;134(Pt 12):3590-601. doi: 10.1093/brain/awr307.
Multiple sclerosis is characterized by inflammatory demyelination and irreversible axonal injury leading to permanent neurological disabilities. Diffusion tensor imaging demonstrates an improved capability over standard magnetic resonance imaging to differentiate axon from myelin pathologies. However, the increased cellularity and vasogenic oedema associated with inflammation cannot be detected or separated from axon/myelin injury by diffusion tensor imaging, limiting its clinical applications. A novel diffusion basis spectrum imaging, capable of characterizing water diffusion properties associated with axon/myelin injury and inflammation, was developed to quantitatively reveal white matter pathologies in central nervous system disorders. Tissue phantoms made of normal fixed mouse trigeminal nerves juxtaposed with and without gel were employed to demonstrate the feasibility of diffusion basis spectrum imaging to quantify baseline cellularity in the absence and presence of vasogenic oedema. Following the phantom studies, in vivo diffusion basis spectrum imaging and diffusion tensor imaging with immunohistochemistry validation were performed on the corpus callosum of cuprizone treated mice. Results demonstrate that in vivo diffusion basis spectrum imaging can effectively separate the confounding effects of increased cellularity and/or grey matter contamination, allowing successful detection of immunohistochemistry confirmed axonal injury and/or demyelination in middle and rostral corpus callosum that were missed by diffusion tensor imaging. In addition, diffusion basis spectrum imaging-derived cellularity strongly correlated with numbers of cell nuclei determined using immunohistochemistry. Our findings suggest that diffusion basis spectrum imaging has great potential to provide non-invasive biomarkers for neuroinflammation, axonal injury and demyelination coexisting in multiple sclerosis.
多发性硬化症的特征是炎症性脱髓鞘和不可逆的轴突损伤,导致永久性神经功能障碍。弥散张量成像(diffusion tensor imaging,DTI)在区分轴突与髓鞘病变方面优于标准磁共振成像(magnetic resonance imaging,MRI)。然而,与炎症相关的细胞增多和血管源性水肿不能通过弥散张量成像来检测或与轴突/髓鞘损伤分离,这限制了其临床应用。一种新的弥散基础谱成像(diffusion basis spectrum imaging,DBSI)能够对与轴突/髓鞘损伤和炎症相关的水分子扩散特性进行特征化,定量揭示中枢神经系统疾病中的白质病变。采用正常固定的小鼠三叉神经组织制成的组织模型,与含有或不含有凝胶的组织模型并列,以证明弥散基础谱成像定量评估无血管源性水肿和存在血管源性水肿时基线细胞增多的可行性。在进行组织模型研究之后,对杯状细胞模型(cuprizone treated mice)的胼胝体进行了弥散基础谱成像和弥散张量成像与免疫组织化学验证。结果表明,体内弥散基础谱成像能够有效地分离细胞增多和/或灰质污染的混杂效应,成功检测到免疫组织化学证实的胼胝体中部和前部的轴突损伤和/或脱髓鞘,而这些损伤在弥散张量成像中被漏诊。此外,弥散基础谱成像得出的细胞数量与免疫组织化学确定的细胞核数量具有很强的相关性。我们的研究结果表明,弥散基础谱成像在多发性硬化症中具有很大的潜力,可为神经炎症、轴突损伤和脱髓鞘提供非侵入性的生物标志物。