Sahin Neslin, Selouan Roger, Markowitz Clyde E, Melhem Elias R, Bilello Michel
Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA Department of Radiology, Sifa University School of Medicine, İzmir, Turkey
Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA.
Acta Radiol. 2016 Mar;57(3):341-7. doi: 10.1177/0284185115578689. Epub 2015 Apr 6.
Multiple sclerosis (MS) is a well-known demyelinating disease to cause cognitive dysfunction. The limbic system, relevant to memory, can be easily overlooked in conventional magnetic resonance imaging (MRI).
To investigate the distribution and frequency of demyelinating lesions affecting white matter connections of the limbic system based on localization with diffusion tensor imaging (DTI)-derived fractional anisotropy (FA) color maps compared to three-dimensional T2-weighted (T2W) and FLAIR volumes in MS patients.
One hundred and fifty patients with a known diagnosis of MS were identified for this Health Insurance Portability and Accountability (HIPAA)-compliant retrospective cross-sectional study. DTI-derived FA color maps, co-registered to T2W and FLAIR images, were analyzed for lesions affecting the three white matter tracts of the limbic system including cingulum, fornix, and mammilothalamic tracts by two investigators. The approximate location of the lesions on FLAIR was always confirmed on the co-registered DTI-derived FA color maps.
Of the 150 patients analyzed, 14.6% had cingulum lesions, 2.6% had fornix lesions, and 2.6% had mammilothalamic tract lesions; 21.3% of patients had at least one of the three tracts affected.
A relatively high frequency of lesions involving the limbic tracts may explain memory deficits and emotional dysfunction commonly experienced by patients with MS. The combined information from T2W, FLAIR, and DTI-derived FA color map allowed for more accurate localization of lesions affecting the major white matter tracts of the limbic system.
多发性硬化症（MS）是一种众所周知的可导致认知功能障碍的脱髓鞘疾病。与记忆相关的边缘系统在传统磁共振成像（MRI）中很容易被忽视。
基于扩散张量成像（DTI）衍生的分数各向异性（FA）彩色图进行定位，与MS患者的三维T2加权（T2W）和液体衰减反转恢复（FLAIR）容积相比，研究影响边缘系统白质连接的脱髓鞘病变的分布和频率。
确定150例已知诊断为MS的患者用于这项符合健康保险流通与责任法案（HIPAA）的回顾性横断面研究。由两名研究人员分析与T2W和FLAIR图像配准的DTI衍生的FA彩色图，以确定影响边缘系统三个白质束（包括扣带束、穹窿和乳头丘脑束）的病变。FLAIR上病变的大致位置总是在配准的DTI衍生的FA彩色图上得到确认。
在分析的150例患者中，14.6%有扣带束病变，2.6%有穹窿病变，2.6%有乳头丘脑束病变；21.3%的患者至少有这三个束中的一个受到影响。
累及边缘束的病变频率相对较高，这可能解释了MS患者常见的记忆缺陷和情绪功能障碍。来自T2W、FLAIR和DTI衍生的FA彩色图的综合信息能够更准确地定位影响边缘系统主要白质束的病变。
