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使用超高 b 值 DWI(UHb-DWI)检测颈髓 MS 病变的高 b 值弥散系数。

High-b diffusivity of MS lesions in cervical spinal cord using ultrahigh-b DWI (UHb-DWI).

机构信息

Utah Center for Advanced Imaging Research, University of Utah, Utah, USA.

Department of Radiology and Imaging Sciences, University of Utah, Utah, USA.

出版信息

Neuroimage Clin. 2021;30:102610. doi: 10.1016/j.nicl.2021.102610. Epub 2021 Mar 8.

DOI:10.1016/j.nicl.2021.102610
PMID:33752076
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7985401/
Abstract

PURPOSE

The purpose of this study was to investigate UHb-rDWI signal in white matter tracts of the cervical spinal cord (CSC) and compare quantitative values between healthy control WM with both MS NAWM and MS WM lesions.

METHODS

UHb-rDWI experiments were performed on (a) 7 MS patients with recently active or chronic lesions in CSC and on (b) 7 healthy control of similar age range and gender distribution to MS subjects. All MRI data were acquired using clinical 3T MRI system. Axial high-b diffusion images were acquired using 2D single-shot DW stimulated EPI with reduced FOV and a CSC-dedicated 8 channel array coil. High-b diffusion coefficient D was estimated by fitting the signal-b curve to a double or single-exponential function.

RESULTS

The high-b diffusivity D values were measured as (0.767 ± 0.297) × 10 mm/s in the posterior column lesions, averaged over 6 MS patients, and 0.587 × 10 mm/s in the corticospinal tract for another patient. The averaged D values of the 7 healthy volunteers from the posterior and lateral column were (0.0312 ± 0.0306) × 10 and (0.0505 ± 0.0205) × 10 mm/s, respectively. UHb-rDWI signal-b curves of the MS patients revealed to noticeably behave differently to that of the healthy controls. The patient signal-b curves decayed with greater high-b decay constants to reach lower signal intensities relative to signal-b curves of the healthy controls.

CONCLUSION

UHb-DWI of the CSC reveals a marked difference in signal-b-curves and D values in MS lesions compared to NAWM and healthy control WM. Based on physical principles, we interpret these altered observations of quantitative diffusion values to be indicative of demyelination. Further studies in animal models will be required to fully interpret UHb-DWI quantitative diffusion values during demyelination and remyelination.

摘要

目的

本研究旨在探讨颈髓(CSC)白质束的 UHb-rDWI 信号,并比较健康对照组 WM 与 MS 正常白质(NAWM)和 MS 白质病变的定量值。

方法

对(a)7 例颈髓新近活动或慢性病变的 MS 患者和(b)7 例年龄和性别分布与 MS 患者相似的健康对照组进行 UHb-rDWI 实验。所有 MRI 数据均采用临床 3T MRI 系统采集。采用 2D 单次激发 DW 激发 EPI 采集轴向高 b 扩散图像,减少 FOV 和 CSC 专用 8 通道阵列线圈。通过将信号-b 曲线拟合到双指数或单指数函数来估计高 b 扩散系数 D。

结果

6 例 MS 患者的后柱病变高 b 扩散系数 D 值平均为(0.767±0.297)×10mm/s,另 1 例患者的皮质脊髓束为 0.587×10mm/s。7 名健康志愿者的后柱和侧柱的平均 D 值分别为(0.0312±0.0306)×10和(0.0505±0.0205)×10mm/s。MS 患者的 UHb-rDWI 信号-b 曲线明显不同于健康对照组。与健康对照组的信号-b 曲线相比,患者的信号-b 曲线衰减更快,达到的信号强度更低。

结论

CSC 的 UHb-DWI 显示,与 NAWM 和健康对照组 WM 相比,MS 病变的信号-b 曲线和 D 值存在显著差异。根据物理原理,我们将这些定量扩散值的改变观察解释为脱髓鞘的指示。需要在动物模型中进一步研究,以充分解释脱髓鞘和髓鞘再生过程中的 UHb-DWI 定量扩散值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4baf/7985401/39b3eb3f9316/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4baf/7985401/4117de650629/ga1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4baf/7985401/382d4fd6685d/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4baf/7985401/2d0e56e75be6/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4baf/7985401/da1bf7c285de/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4baf/7985401/71e08ecdb4e4/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4baf/7985401/39b3eb3f9316/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4baf/7985401/4117de650629/ga1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4baf/7985401/382d4fd6685d/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4baf/7985401/2d0e56e75be6/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4baf/7985401/da1bf7c285de/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4baf/7985401/71e08ecdb4e4/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4baf/7985401/39b3eb3f9316/gr5.jpg

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本文引用的文献

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Imaging outcome measures for progressive multiple sclerosis trials.多发性硬化症临床试验的影像学结局指标。
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Molecular and Metabolic Imaging in Multiple Sclerosis.多发性硬化症的分子与代谢成像
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Characterization of spinal cord white matter by suppressing signal from hindered space. A Monte Carlo simulation and an ex vivo ultrahigh-b diffusion-weighted imaging study.通过抑制受限空间信号对脊髓白质进行表征:蒙特卡罗模拟与离体超高b值扩散加权成像研究
J Magn Reson. 2016 Nov;272:53-59. doi: 10.1016/j.jmr.2016.09.001. Epub 2016 Sep 4.
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Two-dimensional single-shot diffusion-weighted stimulated EPI with reduced FOV for ultrahigh-b radial diffusion-weighted imaging of spinal cord.用于脊髓超高b值径向扩散加权成像的二维单次激发扩散加权刺激回波平面成像,采用缩小视野技术
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