Müller Hans-Peter, Nagel Armin M, Keidel Franziska, Wunderlich Arthur, Hübers Annemarie, Gast Lena V, Ludolph Albert C, Beer Meinrad, Kassubek Jan
Department of Neurology, University of Ulm, Ulm, Germany.
Institute of Radiology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
Ther Adv Chronic Dis. 2022 Jul 8;13:20406223221109480. doi: 10.1177/20406223221109480. eCollection 2022.
Multiparametric magnetic resonance imaging (MRI) is established as a technical instrument for the characterisation of patients with amyotrophic lateral sclerosis (ALS). The contribution of relaxation-weighted sodium (NaR) MRI remains to be defined. The aim of this study is to apply NaR MRI to investigate brain sodium homeostasis and map potential alterations in patients with ALS as compared with healthy controls.
Seventeen patients with ALS (mean age 61.1 ± 11.4 years, m/f = 9/8) and 10 healthy control subjects (mean age 60.3 ± 15.3 years, m/f = 6/4) were examined by NaR MRI at 3 T. Regional sodium maps were obtained by the calculation of the weighted difference from two image data sets with different echo times (TE = 0.3 ms, TE = 25 ms). Voxel-based analysis of the relaxation-weighted maps, together with Na concentration maps for comparison, was performed.
ROI-based analyses of relaxation-weighted brain sodium concentration maps demonstrated increased sodium concentrations in the upper corticospinal tracts and in the frontal lobes in patients with ALS; no differences between ALS patients and controls were found in reference ROIs, where no involvement in ALS-associated neurodegeneration could be anticipated.
NaR MRI mapped regional alterations within disease-relevant areas in ALS which correspond to the stages of the central nervous system (CNS) pathology, providing evidence that the technique is a potential biological marker of the cerebral neurodegenerative process in ALS.
多参数磁共振成像（MRI）已成为用于表征肌萎缩侧索硬化症（ALS）患者的一项技术手段。弛豫加权钠（NaR）MRI的作用仍有待明确。本研究的目的是应用NaR MRI来研究ALS患者的脑钠稳态，并描绘出与健康对照相比ALS患者潜在的变化情况。
17例ALS患者（平均年龄61.1±11.4岁，男/女 = 9/8）和10名健康对照者（平均年龄60.3±15.3岁，男/女 = 6/4）接受了3T的NaR MRI检查。通过计算来自两个具有不同回波时间（TE = 0.3 ms，TE = 25 ms）的图像数据集的加权差值来获得区域钠图。对弛豫加权图进行基于体素的分析，并与钠浓度图进行比较。
基于感兴趣区（ROI）对弛豫加权脑钠浓度图的分析表明，ALS患者的上皮质脊髓束和额叶中的钠浓度升高；在预期不会发生与ALS相关神经变性的参考ROI中，未发现ALS患者与对照之间存在差异。
NaR MRI描绘了ALS中与疾病相关区域内的区域变化，这些变化与中枢神经系统（CNS）病理阶段相对应，这表明该技术是ALS中脑 neurodegenerative过程的潜在生物学标志物。 （注：“neurodegenerative”直译为“神经退行性”，这里结合语境意译为“神经变性”更合适，但题目要求不添加解释说明，所以保留英文）
