Onu Mihaela, Aroceanu Adina, Ferastraoaru Victor, Bajenaru Ovidiu
Department of Medical Imaging, Clinical Hospital "Prof. Dr. Th. Burghele", Bucharest, Romania.
Department of Neurology, Emergency University Hospital, Bucharest, Romania.
Maedica (Bucur). 2015 Sep;10(4):319-324.
Recent MR studies have shown that, in multiple sclerosis, selective regional, but not global gray matter atrophy occurs in multiple sclerosis. Our aim was to identify specific areas of gray matter volume changes and explore the relationship between atrophy and clinical motor outcomes.
Nine patients with relapsing remitting MS and 9 matched healthy controls were recruited. The Multiple Sclerosis Functional Composite was administered. For MR acquisitions, a GE- Genesis- Signa, 1.5T MR system, was used. A voxel-based morphometry (VBM), subcortical structures segmentation (FIRST) and volumetric (SIENAx) FSL tools were used in the study.
Group comparison showed atrophy for several gray matter regions. The most important volume reductions were found for subcortical deep gray matter areas. Correlations with clinical scores were checked and specific gray matter areas showed significant volume reductions associated with motor scores (9-hole peg time and 25-feet walk time) and EDSS (Expanded Disability Status Scale).
We performed a voxelwise analysis of gray matter changes in MS and found a more prominent atrophy for the subcortical structures than for cortical gray matter. Using an additional analysis (FIRST and SIENAx segmentation/volumetry) we were able to confirm the VBM results and to quantify the degree of atrophy in specific structures. Specific gray matter regions which volume reductions correlate with 25-feet walk, 9-hole peg times and EDSS suggest that 25-feet walk time is the best predictor of disease progression in terms of gray matter reduction.
近期的磁共振成像（MR）研究表明，在多发性硬化症中，灰质萎缩呈选择性区域分布，而非全脑萎缩。我们的目的是确定灰质体积变化的特定区域，并探讨萎缩与临床运动结果之间的关系。
招募了9例复发缓解型多发性硬化症患者和9名匹配的健康对照者。采用多发性硬化症功能综合评分。MR图像采集使用GE - Genesis - Signa 1.5T MR系统。本研究使用了基于体素的形态学测量（VBM）、皮质下结构分割（FIRST）和容积测量（SIENAx）等FSL工具。
组间比较显示多个灰质区域存在萎缩。皮质下深部灰质区域的体积减少最为明显。检查了与临床评分的相关性，特定灰质区域显示出与运动评分（9孔插针时间和25英尺步行时间）以及扩展残疾状态量表（EDSS）相关的显著体积减少。
我们对多发性硬化症患者的灰质变化进行了体素分析，发现皮质下结构的萎缩比皮质灰质更为明显。通过额外的分析（FIRST和SIENAx分割/容积测量），我们能够证实VBM结果并量化特定结构的萎缩程度。灰质体积减少与25英尺步行、9孔插针时间和EDSS相关的特定灰质区域表明，就灰质减少而言，25英尺步行时间是疾病进展的最佳预测指标。
