Barkhof F, McGowan J C, van Waesberghe J H, Grossman R I
MR Centre for MS Research, Department of Diagnostic Radiology, Vrije Universiteit Hospital, Amsterdam, The Netherlands.
J Neurol Neurosurg Psychiatry. 1998 May;64 Suppl 1:S77-9.
The predictive value of T2-weighted imaging in multiple sclerosis is only moderate, due to low specificity of high signal on such images. Among new MR techniques with acclaimed higher pathological specificity, hypointense lesions on moderately T1-weighted spin echo images show improved correlation with disability. The degree of hypointensity of so called black holes correlates with loss of magnetisation transfer, a marker of matrix destruction. Severe tissue loss is also shown histopathologically in a post-mortem MR study of black holes. In this review unresolved issues regarding black holes are discussed including standardisation of sequences, definition of hypointensity, interobserver variation in measuring lesion load with this technique, and significance of acute black holes. The role of black holes in monitoring treatment efficacy is as yet unexplored.
由于T2加权成像上高信号的特异性较低，其在多发性硬化症中的预测价值仅为中等。在具有更高病理特异性的新型磁共振成像（MR）技术中，中等T1加权自旋回波图像上的低信号病变与残疾的相关性更好。所谓“黑洞”的低信号程度与磁化传递丧失相关，磁化传递丧失是基质破坏的一个标志。在一项关于“黑洞”的尸检MR研究中，组织病理学也显示了严重的组织损失。在这篇综述中，讨论了有关“黑洞”的未解决问题，包括序列标准化、低信号的定义、使用该技术测量病变负荷时观察者间的差异以及急性“黑洞”的意义。“黑洞”在监测治疗效果中的作用尚未得到探索。
