Department of Neuroinflammation, UCL Institute of Neurology, Queen Square MS Centre, London, UK.
Department of Radiology and Radiotherapy E01.132, University Medical Centre Utrecht, Utrecht, The Netherlands.
J Cereb Blood Flow Metab. 2014 Jan;34(1):34-42. doi: 10.1038/jcbfm.2013.161. Epub 2013 Sep 18.
Alterations in the overall cerebral hemodynamics have been reported in multiple sclerosis (MS); however, their cause and significance is unknown. While potential venous causes have been examined, arterial causes have not. In this study, a multiple delay time arterial spin labeling magnetic resonance imaging sequence at 3T was used to quantify the arterial hemodynamic parameter bolus arrival time (BAT) and cerebral blood flow (CBF) in normal-appearing white matter (NAWM) and deep gray matter in 33 controls and 35 patients with relapsing-remitting MS. Bolus arrival time was prolonged in MS in NAWM (1.0±0.2 versus 0.9±0.2 seconds, P=0.031) and deep gray matter (0.90±0.18 versus 0.80±0.14 seconds, P=0.001) and CBF was increased in NAWM (14±4 versus 10±2 mL/100 g/min, P=0.001). Prolonged BAT in NAWM (P=0.042) and deep gray matter (P=0.01) were associated with higher expanded disability status score. This study demonstrates alteration in cerebral arterial hemodynamics in MS. One possible cause may be widespread inflammation. Bolus arrival time was longer in patients with greater disability independent of atrophy and T2 lesion load, suggesting alterations in cerebral arterial hemodynamics may be a marker of clinically relevant pathology.
多发性硬化症（MS）患者的脑总体血流动力学发生改变，但病因和意义尚不清楚。虽然已经检查了潜在的静脉原因，但动脉原因尚未被检查。在这项研究中，我们使用 3T 的多延迟时间动脉自旋标记磁共振成像序列，在 33 名对照者和 35 名复发缓解型 MS 患者的正常表现白质（NAWM）和深部灰质中定量动脉血流动力学参数的示踪剂到达时间（BAT）和脑血流（CBF）。MS 患者的 NAWM（1.0±0.2 比 0.9±0.2 秒，P=0.031）和深部灰质（0.90±0.18 比 0.80±0.14 秒，P=0.001）的示踪剂到达时间延长，而 NAWM 的 CBF 增加（14±4 比 10±2 毫升/100 克/分钟，P=0.001）。NAWM（P=0.042）和深部灰质（P=0.01）中延长的 BAT 与更高的扩展残疾状态评分有关。这项研究表明，MS 患者的脑动脉血流动力学发生改变。一个可能的原因可能是广泛的炎症。与萎缩和 T2 病变负荷无关，残疾程度较高的患者的示踪剂到达时间更长，这表明脑动脉血流动力学的改变可能是与临床相关的病理学的标志物。
