Zhu Qiyuan, Zheng Qiao, Luo Dan, Peng Yuling, Yan Zichun, Wang Xiaohua, Chen Xiaoya, Li Yongmei
Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Front Neurosci. 2022 Mar 10;16:849425. doi: 10.3389/fnins.2022.849425. eCollection 2022.
To evaluate the microstructural damage in the heterogeneity of different white matter areas in relapsing-remitting multiple sclerosis (RRMS) patients by using diffusion kurtosis imaging (DKI) and its correlation with clinical and cognitive status.
Kurtosis fractional anisotropy (KFA), fractional anisotropy (FA), mean kurtosis (MK), and mean diffusivity (MD) in T1-hypointense lesions (T1Ls), pure T2-hyperintense lesions (pure-T2Ls), normal-appearing white matter (NAWM), and white matter in healthy controls (WM in HCs) were measured in 48 RRMS patients and 26 sex- and age-matched HCs. All the participants were assessed with the Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), and the Symbol Digit Modalities Test (SDMT) scores as the cognitive status. The Kurtzke Expanded Disability Status Scale (EDSS) scores were used to evaluate the clinical status in RRMS patients.
The lowest KFA, FA, and MK values and the highest MD values were found in T1Ls, followed by pure-T2Ls, NAWM, and WM in HCs. The T1Ls and pure-T2Ls were significantly different in FA ( = 0.002) and MK ( = 0.013), while the NAWM and WM in HCs were significantly different in KFA, FA, and MK ( < 0.001; < 0.001; = 0.001). The KFA, FA, MK, and MD values in NAWM ( = 0.360, = 0.014; = 0.415, = 0.004; = 0.369, = 0.012; = -0.531, < 0.001) were correlated with the MMSE scores and the FA, MK, and MD values in NAWM ( = 0.423, = 0.003; = 0.427, = 0.003; = -0.359, = 0.014) were correlated with the SDMT scores.
Applying DKI to the imaging-based white matter classification has the potential to reflect the white matter damage and is correlated with cognitive impairment.
运用扩散峰度成像（DKI）评估复发缓解型多发性硬化症（RRMS）患者不同白质区域异质性中的微观结构损伤及其与临床和认知状态的相关性。
测量48例RRMS患者和26例年龄及性别匹配的健康对照者（HCs）的T1低信号病变（T1Ls）、单纯T2高信号病变（单纯-T2Ls）、正常表现白质（NAWM）以及HCs中的白质（WM in HCs）的峰度分数各向异性（KFA）、分数各向异性（FA）、平均峰度（MK）和平均扩散率（MD）。所有参与者均接受简易精神状态检查表（MMSE）、蒙特利尔认知评估量表（MoCA）和符号数字模式测验（SDMT）评分以评估认知状态。采用Kurtzke扩展残疾状态量表（EDSS）评分评估RRMS患者的临床状态。
T1Ls中KFA、FA和MK值最低，MD值最高，其次为单纯-T2Ls、NAWM和HCs中的WM。T1Ls与单纯-T2Ls在FA（ = 0.002）和MK（ = 0.013）方面存在显著差异，而NAWM与HCs中的WM在KFA、FA和MK方面存在显著差异（ < 0.001； < 0.001； = 0.001）。NAWM中的KFA、FA、MK和MD值（ = 0.360， = 0.014； = 0.415， = 0.004； = 0.369， = 0.012； = -0.531， < 0.001）与MMSE评分相关，NAWM中的FA、MK和MD值（ = 0.423， = 0.003； = 0.427， = 0.003； = -0.359， = 0.014）与SDMT评分相关。
将DKI应用于基于成像的白质分类有可能反映白质损伤并与认知障碍相关。
