Falini A, Calabrese G, Filippi M, Origgi D, Lipari S, Colombo B, Comi G, Scotti G
Department of Neuroradiology, Scientific Institute San Raffaele Hospital, University of Milan, Italy.
AJNR Am J Neuroradiol. 1998 Feb;19(2):223-9.
We determined the clinical utility of proton MR spectroscopy in defining the extent of disability in benign versus secondary-progressive multiple sclerosis (MS).
Thirty patients with clinically definite MS, including 16 patients with benign MS and 14 with secondary-progressive MS, and a group of 13 healthy volunteers were studied with combined stimulated-echo acquisition mode proton MR spectroscopy and MR imaging (all patients received contrast material).
Acute enhancing lesions of benign and secondary-progressive MS were characterized by a reduction in N-acetylaspartate (NAA)/choline and NAA/creatine and an increase in inositol compounds/creatine as compared with normal white matter. Such variations were also detected in chronic unenhancing lesions in patients with secondary-progressive MS, although they were not found in chronic unenhancing lesions in patients with benign MS. Chronic lesions of the two forms of the disease have significative differences in NAA and inositol signals.
Proton MR spectroscopy is able to show metabolic changes occurring in the white matter of patients with MS. Such changes differ according to the phase (acute versus chronic) and the clinical form (benign versus secondary-progressive) of the disease.
我们确定了质子磁共振波谱在界定良性与继发进展型多发性硬化（MS）残疾程度方面的临床效用。
对30例临床确诊的MS患者进行了研究，其中包括16例良性MS患者和14例继发进展型MS患者，同时纳入13名健康志愿者作为对照组。所有患者均接受了联合刺激回波采集模式质子磁共振波谱及磁共振成像检查（所有患者均使用了对比剂）。
与正常白质相比，良性和继发进展型MS的急性强化病灶表现为N-乙酰天门冬氨酸（NAA）/胆碱及NAA/肌酸降低，肌醇化合物/肌酸升高。继发进展型MS患者的慢性非强化病灶也检测到了类似变化，而良性MS患者的慢性非强化病灶未出现此变化。两种类型疾病的慢性病灶在NAA和肌醇信号方面存在显著差异。
质子磁共振波谱能够显示MS患者白质中发生的代谢变化。这些变化因疾病阶段（急性与慢性）及临床类型（良性与继发进展型）而异。
