Yaldizli Özgür, Pardini Matteo, Sethi Varun, Muhlert Nils, Liu Zheng, Tozer Daniel J, Samson Rebecca S, Wheeler-Kingshott Claudia Am, Yousry Tarek A, Miller David H, Chard Declan T
Queen Square MS Centre, UCL Institute of Neurology, UK/MS Center, University Hospital Basel, Switzerland
Queen Square MS Centre, UCL Institute of Neurology, UK/Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy.
Mult Scler. 2016 Feb;22(2):150-9. doi: 10.1177/1352458515586085. Epub 2015 May 26.
In multiple sclerosis (MS), diffusion tensor and magnetisation transfer imaging are both abnormal in lesional and extra-lesional cortical grey matter, but differences between clinical subtypes and associations with clinical outcomes have only been partly assessed.
To compare mean diffusivity, fractional anisotropy and magnetisation transfer ratio (MTR) in cortical grey matter lesions (detected using phase-sensitive inversion recovery (PSIR) imaging) and extra-lesional cortical grey matter, and assess associations with disability in relapse-onset MS.
Seventy-two people with MS (46 relapsing-remitting (RR), 26 secondary progressive (SP)) and 36 healthy controls were included in this study. MTR, mean diffusivity and fractional anisotropy were measured in lesional and extra-lesional cortical grey matter.
Mean fractional anisotropy was higher and MTR lower in lesional compared with extra-lesional cortical grey matter. In extra-lesional cortical grey matter mean fractional anisotropy and MTR were lower, and mean diffusivity was higher in the MS group compared with controls. Mean MTR was lower and mean diffusivity was higher in lesional and extra-lesional cortical grey matter in SPMS when compared with RRMS. These differences were independent of disease duration. In multivariate analyses, MTR in extra-lesional more so than lesional cortical grey matter was associated with disability.
Magnetic resonance abnormalities in lesional and extra-lesional cortical grey matter are greater in SPMS than RRMS. Changes in extra-lesional compared with lesional cortical grey matter are more consistently associated with disability.
在多发性硬化症（MS）中，扩散张量成像和磁化传递成像在病灶及病灶外皮质灰质中均显示异常，但临床亚型之间的差异以及与临床结局的关联仅得到部分评估。
比较皮质灰质病灶（使用相位敏感反转恢复（PSIR）成像检测）和病灶外皮质灰质中的平均扩散率、分数各向异性和磁化传递率（MTR），并评估复发型MS中与残疾的关联。
本研究纳入了72例MS患者（46例复发缓解型（RR），26例继发进展型（SP））和36名健康对照者。测量病灶及病灶外皮质灰质中的MTR、平均扩散率和分数各向异性。
与病灶外皮质灰质相比，病灶内的平均分数各向异性更高，MTR更低。在病灶外皮质灰质中，MS组的平均分数各向异性和MTR更低，平均扩散率更高。与RRMS相比，SPMS病灶及病灶外皮质灰质中的平均MTR更低，平均扩散率更高。这些差异与病程无关。在多变量分析中，病灶外而非病灶内皮质灰质的MTR与残疾相关。
SPMS病灶及病灶外皮质灰质中的磁共振异常比RRMS更明显。与病灶内皮质灰质相比，病灶外皮质灰质的变化与残疾的相关性更一致。
