Niess Eva, Dal-Bianco Assunta, Strasser Bernhard, Niess Fabian, Hingerl Lukas, Bachrata Beata, Motyka Stanislav, Rommer Paulus, Trattnig Siegfried, Bogner Wolfgang
High-Field MR Center, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.
Department of Neurology, Medical University of Vienna, Vienna, Austria.
Neuroimage. 2025 Mar;308:121043. doi: 10.1016/j.neuroimage.2025.121043. Epub 2025 Jan 24.
To assess topographical patterns of metabolic abnormalities in the cerebrum of multiple sclerosis (MS) patients and their relationship to clinical disability using rapid echo-less 3D-MR spectroscopic imaging (MRSI) at 7T.
This study included 26 MS patients (13 women; median age 34) and 13 age- and sex-matched healthy controls (7 women; median age 33). Metabolic maps were obtained using echo-less 3D-MRSI at 7T with a 64 × 64 × 33 matrix and a nominal voxel size of 3.4 × 3.4 × 4 mm³ in an 8-minute scan. After spatial normalization, voxel-wise comparisons between MS and controls were conducted to identify clusters of metabolic abnormalities, while correlations with clinical disability were analyzed using Expanded Disability Status Scale (EDSS) scores.
Statistical mapping (FWE-corrected; P<.05) revealed elevated myo-inositol to total creatine (mI/tCr) ratios in the bilateral periventricular white matter and reduced N-acetylaspartate to total creatine (NAA/tCr) within and beyond lesions, notably near the lateral ventricles, cingulate gyrus, and superior frontal gyrus. Patients with sustained disability (EDSS≥2) showed additional reductions in the posterior parietal lobe. A strong negative association was found between NAA/tCr and EDSS in the precentral gyrus (Spearman's rank ρ=-0.58, P=.005), and a moderate positive association between mI/NAA and EDSS in the precentral and superior frontal gyri (ρ=0.47, P=.015).
This study highlights the ability of 3D-MRSI at 7T to map widespread metabolic abnormalities in MS, with NAA reductions in prefrontal, motor, and sensory areas, linked to neuroaxonal damage and disability progression, and elevated mI in periventricular regions, reflecting gliosis.
利用7T快速无回波三维磁共振波谱成像（MRSI）评估多发性硬化症（MS）患者大脑中代谢异常的拓扑模式及其与临床残疾的关系。
本研究纳入26例MS患者（13名女性；中位年龄34岁）和13名年龄及性别匹配的健康对照者（7名女性；中位年龄33岁）。在7T条件下使用无回波三维MRSI，以64×64×33矩阵及名义体素大小3.4×3.4×4mm³进行8分钟扫描，获取代谢图谱。经空间归一化后，对MS患者和对照者进行体素水平比较以识别代谢异常簇，同时使用扩展残疾状态量表（EDSS）评分分析与临床残疾的相关性。
统计图谱分析（FWE校正；P<0.05）显示，双侧脑室周围白质中肌醇与总肌酸（mI/tCr）比值升高，病变内及病变外（尤其是侧脑室附近、扣带回和额上回）N-乙酰天门冬氨酸与总肌酸（NAA/tCr）比值降低。持续残疾（EDSS≥2）的患者顶叶后部NAA/tCr比值进一步降低。中央前回中NAA/tCr与EDSS之间存在强负相关（Spearman等级相关系数ρ=-0.58，P=0.005），中央前回和额上回中mI/NAA与EDSS之间存在中度正相关（ρ=0.47，P=0.015）。
本研究强调了7T三维MRSI描绘MS广泛代谢异常的能力，前额叶、运动和感觉区域NAA降低与神经轴突损伤及残疾进展相关，脑室周围区域mI升高反映胶质增生。
