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使用扩散张量成像对复发缓解型多发性硬化症胼胝体异常进行定量评估:一项系统评价和荟萃分析。

Quantitative evaluation of callosal abnormalities in relapsing-remitting multiple sclerosis using diffusion tensor imaging: A systemic review and meta-analysis.

作者信息

Xu Lu, Chang Sheng-Hui, Yang Li, Zhang Lin-Jie

机构信息

Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, 300052, PR China.

Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, 300052, PR China.

出版信息

Clin Neurol Neurosurg. 2021 Feb;201:106442. doi: 10.1016/j.clineuro.2020.106442. Epub 2020 Dec 24.

DOI:10.1016/j.clineuro.2020.106442
PMID:33373835
Abstract

BACKGROUND

Although the changes of diffusion tensor imaging (DTI) in corpus callosum (CC) in patients with relapsing-remitting multiple sclerosis (RRMS) has been reported, the results are controversial. We aimed to determine the damage to the CC in patients with RRMS using DTI.

MATERIAL AND METHODS

A systematic search of English databases (PubMed, Embase, Cochrane Library, and Scopus) was performed. Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) values of DTI were compared between RRMS patients and healthy controls (HC) using Stata 12.0.

RESULTS

A total of 461 patients and 365 HC from 15 studies were included. Compared with HC, the FA values of the whole CC (SMD -1.894, P < 0.001), genu (SMD -0.830, P < 0.001) and splenium (SMD -1.431, P < 0.001) of CC were significantly reduced in patients with RRMS. Moreover, the MD values of the whole CC (SMD 1.213, P < 0.001), genu (SMD 0.657, P < 0.001) and splenium (SMD 0.830, P < 0.001) of CC were significantly increased in patients with RRMS. Additionally, the AD values (SMD 0.635, P < 0.001) and RD values (SMD 1.480, P < 0.001) were significantly increased in the whole CC in patients with RRMS. The meta-regression analysis revealed that the male ratio showed a significant effect on the FA reduction in the splenium CC in RRMS patients.

CONCLUSIONS

These results indicated that DTI parameters were potential biomarkers with increased sensitivity for detecting pathological damage in the CC in patients with RRMS.

摘要

背景

尽管已有报道复发缓解型多发性硬化症(RRMS)患者胼胝体(CC)的扩散张量成像(DTI)变化,但结果存在争议。我们旨在使用DTI确定RRMS患者CC的损伤情况。

材料与方法

对英文数据库(PubMed、Embase、Cochrane图书馆和Scopus)进行系统检索。使用Stata 12.0比较RRMS患者和健康对照(HC)之间DTI的分数各向异性(FA)、平均扩散率(MD)、轴向扩散率(AD)和径向扩散率(RD)值。

结果

共纳入15项研究中的461例患者和365例HC。与HC相比,RRMS患者CC的整个CC(标准化均数差 -1.894,P < 0.001)、膝部(标准化均数差 -0.830,P < 0.001)和压部(标准化均数差 -1.431,P < 0.001)的FA值显著降低。此外,RRMS患者CC的整个CC(标准化均数差1.213,P < 0.001)、膝部(标准化均数差0.657,P < 0.001)和压部(标准化均数差0.830,P < 0.001)的MD值显著升高。此外,RRMS患者整个CC的AD值(标准化均数差0.635,P < 0.001)和RD值(标准化均数差1.480,P < 0.001)显著升高。Meta回归分析显示,男性比例对RRMS患者压部CC的FA降低有显著影响。

结论

这些结果表明,DTI参数是检测RRMS患者CC病理损伤的潜在生物标志物,具有更高的敏感性。

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