Heide A C, Kraft G H, Slimp J C, Gardner J C, Posse S, Serafini S, Bowen J D, Richards T L
Department of Radiology, University of Washington, Seattle, USA.
AJNR Am J Neuroradiol. 1998 Jun-Jul;19(6):1047-54.
Our purpose was to compare cerebral proton MR metabolite changes in patients with multiple sclerosis (MS) and abnormal visual evoked potentials (VEPs) with those in MS patients with normal VEPs.
Seventeen subjects with clinically definite MS were studied with VEPs and MR spectroscopic imaging. Proton MR metabolites were measured using a fast spectroscopic imaging technique called proton echo-planar spectroscopic imaging (PEPSI). Kurtzke's Expanded Disability Status Scale (EDSS) score was also ascertained for each subject to obtain a clinical rating. Twelve regions of interest within the visual pathway of the cerebrum were evaluated for levels of N-acetylaspartate (NAA), choline, creatine, and the presence or absence of MR-detectable lesions.
PEPSI NAA values (water-normalized, CSF-corrected) were significantly lower in MS subjects with abnormal VEPs than in subjects with normal VEPs. MR-detectable lesion fractions and EDSS scores were also significantly different between the two VEP groups, but NAA comparison had a P value 100 times less than either of these measures.
In patients with MS, NAA measurements in the optic pathways of the brain were sensitive to VEP abnormalities. NAA was more sensitive to VEP changes than were choline, creatine, MR-detectable lesions, and EDSS score.
我们的目的是比较多发性硬化症（MS）患者且视觉诱发电位（VEP）异常与VEP正常的MS患者脑内质子磁共振代谢物的变化。
对17例临床确诊的MS患者进行VEP和磁共振波谱成像研究。使用一种称为质子回波平面波谱成像（PEPSI）的快速波谱成像技术测量质子磁共振代谢物。还确定了每个受试者的Kurtzke扩展残疾状态量表（EDSS）评分以获得临床评级。评估大脑视觉通路内的12个感兴趣区域的N-乙酰天门冬氨酸（NAA）、胆碱、肌酸水平以及是否存在磁共振可检测病变。
VEP异常的MS受试者的PEPSI NAA值（水归一化、脑脊液校正后）显著低于VEP正常的受试者。两个VEP组之间的磁共振可检测病变比例和EDSS评分也有显著差异，但NAA比较的P值比这些指标中的任何一个小100倍。
在MS患者中，大脑视通路中的NAA测量对VEP异常敏感。NAA对VEP变化的敏感性高于胆碱、肌酸、磁共振可检测病变和EDSS评分。
