Borsodi Florian, Culea Valeriu, Langkammer Christian, Khalil Michael, Pirpamer Lukas, Quasthoff Stefan, Enzinger Christian, Schmidt Reinhold, Fazekas Franz, Ropele Stefan
Department of Neurology, Medical University of Graz, Graz, Austria.
Department of Radiology, Division of Neuroradiology, Medical University of Graz, Graz, Austria.
PLoS One. 2017 Jun 2;12(6):e0178371. doi: 10.1371/journal.pone.0178371. eCollection 2017.
Several quantitative magnetic resonance imaging (MRI) techniques have been proposed to investigate microstructural tissue changes in amyotrophic lateral sclerosis (ALS) including diffusion tensor imaging (DTI), magnetization transfer imaging, and R2* mapping. Here, in this study, we compared these techniques with regard to their capability for detecting ALS related white matter (WM) changes in the brain and their association with clinical findings. We examined 27 ALS patients and 35 age-matched healthy controls. MRI was performed at 3T, after which we analyzed the diffusion properties, the magnetization transfer ratio (MTR), and the effective transversal relaxation rate R2* in 18 WM tracts that were obtained by a fully automated segmentation technique. ALS patients, especially with a bulbar onset, showed a bilateral increase in radial and mean diffusivity, as well as a reduction in fractional anisotropy of the corticospinal tract (CST), and diffusion changes in the parietal and temporal superior longitudinal fasciculus. A reduction of the MTR was found in both CSTs and an R2* reduction was seen only in the left CST. Tract-specific diffusion properties were not related to clinical status in a cross-sectional manner but demonstrated some association with disease progression over three subsequent months. DTI reveals more widespread WM tissue changes than MTR and R2*. These changes are not restricted to the CST, but affect also other WM tracts (especially in patients with bulbar onset), and are associated with the short term course of the disease.
已经提出了几种定量磁共振成像（MRI）技术来研究肌萎缩侧索硬化症（ALS）中的微观结构组织变化，包括扩散张量成像（DTI）、磁化传递成像和R2映射。在本研究中，我们比较了这些技术在检测大脑中与ALS相关的白质（WM）变化的能力及其与临床发现的关联。我们检查了27例ALS患者和35例年龄匹配的健康对照。在3T下进行MRI检查，之后我们分析了通过全自动分割技术获得的18条WM束中的扩散特性、磁化传递率（MTR）和有效横向弛豫率R2。ALS患者，尤其是延髓起病的患者，表现出双侧径向和平均扩散率增加，以及皮质脊髓束（CST）的分数各向异性降低，顶叶和颞叶上纵束的扩散也发生变化。在双侧CST中均发现MTR降低，仅在左侧CST中发现R2降低。特定束的扩散特性在横断面分析中与临床状态无关，但在随后的三个月中显示出与疾病进展有一定关联。DTI显示的WM组织变化比MTR和R2更广泛。这些变化不仅限于CST，还影响其他WM束（尤其是延髓起病的患者），并且与疾病的短期病程相关。
