Filippi M, Mastronardo G, Rocca M A, Pereira C, Comi G
Department of Neurology, Scientific Institute Ospedale San Raffaele, University of Milan, Italy.
J Neurol Sci. 1998 Jun 30;158(2):148-53. doi: 10.1016/s0022-510x(98)00110-5.
We compared the volumes of the brain as a whole and of different cerebral structures from patients with multiple sclerosis (MS) and normal subjects. In the patients, we also correlated brain volumes with T2 and T1 lesion loads and disability. A magnetization-prepared rapid acquisition gradient echo (MP RAGE) sequence with subsequent reconstruction of axial 1-mm thick slices and a dual-echo sequence were obtained in 15 patients with relapsing-remitting or secondary progressive MS and 15 sex-, age-, height- and weight-matched normal subjects. The brains and the different cerebral structures studied (cerebral hemispheres, cerebellum and brainstem) were segmented manually by a single observer on the 1-mm MP RAGE scans. The hyperintense lesion volumes seen on dual-echo scans and the hypointense lesion volumes seen on the 1-mm MP RAGE scans were measured using a semi-automated segmentation technique based on local thresholding. Compared to the normal volunteers, patients had significantly lower cerebral (P = 0.008), hemispheric (P = 0.01) and brainstem (P = 0.03) volumes. Cerebral atrophy was detected in seven (47%) MS patients. Patients with brainstem signs had significantly lower mean brainstem volume than the others (P = 0.04). No significant correlations were found between the cerebral volumes and the EDSS scores, the hyperintense lesion volumes and the hypointense lesion volumes. We conclude that cerebral atrophy is a relatively frequent finding in MS, but its relationship with physical disability is modest.
我们比较了多发性硬化症（MS）患者与正常受试者的全脑及不同脑结构的体积。对于患者，我们还将脑体积与T2和T1病灶负荷及残疾程度进行了关联分析。对15例复发缓解型或继发进展型MS患者以及15名性别、年龄、身高和体重匹配的正常受试者，采用磁化准备快速采集梯度回波（MP RAGE）序列，随后重建1毫米厚的轴向切片，并获取双回波序列。由一名观察者在1毫米的MP RAGE扫描图像上手动分割所研究的大脑及不同脑结构（大脑半球、小脑和脑干）。使用基于局部阈值的半自动分割技术测量双回波扫描上所见的高信号病灶体积以及1毫米MP RAGE扫描上所见的低信号病灶体积。与正常志愿者相比，患者的脑体积（P = 0.008）、半球体积（P = 0.01）和脑干体积（P = 0.03）显著更低。在7例（47%）MS患者中检测到脑萎缩。有脑干体征的患者平均脑干体积显著低于其他患者（P = 0.04）。未发现脑体积与扩展残疾状态量表（EDSS）评分、高信号病灶体积和低信号病灶体积之间存在显著相关性。我们得出结论，脑萎缩在MS中是相对常见的表现，但其与身体残疾的关系不大。
