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目的通过扩散张量成像(DTI)比较视神经脊髓炎和多发性硬化患者与正常对照者常规MRI表现正常脊髓的扩散性差异,并探讨其临床应用价值。方法采用平面回波成像技术对10例视神经脊髓炎、14例多发性硬化患者和13例正常对照者进行颈髓DTI检查,分别测量颈椎C2~5水平前索、侧索、后索和灰质兴趣区的部分各向异性(FA)和平均扩散率(MD)。结果与正常对照组相比,视神经脊髓炎组患者前索、侧索、后索FA值降低(均P<0.05),左侧侧索、后索、灰质MD值升高(均P≤0.05);多发性硬化组患者右侧侧索、后索FA值降低(均P<0.05)。与多发性硬化患者相比,视神经脊髓炎患者侧索FA值更低,左侧侧索和右侧后索MD值更高(均P<0.05)。结论 DTI可以检出视神经脊髓炎和多发性硬化患者常规MRI表现正常脊髓的水分子扩散异常,进而发现二者脊髓扩散指标的差异性,为早期诊断与鉴别诊断提供重要信息。
Objective To compare the diffusivity of normal spinal cord with conventional MRI in optic neuromyelitis and multiple sclerosis and normal controls by diffusion tensor imaging (DTI) and to explore its clinical value. Methods 10 cases of optic neuromyelitis, 14 cases of multiple sclerosis and 13 normal controls were studied by plane echo imaging. The cervical spinal cord DTI was examined by plane echo imaging. The interest of anterior, lateral, posterior and gray matter of cervical C2-5 levels were measured respectively Partial anisotropy (FA) and average diffusivity (MD) of the area. Results Compared with the normal control group, the FA value of the optic nerve myelitis group decreased (all P <0.05), the left lateral cord, posterior cord and gray matter increased (all P≤0.05) ; FA patients with multiple sclerosis in the right side of the cable, FA value decreased (all P <0.05). Compared with patients with multiple sclerosis, optic neuromyelitis patients had lower FA and lower MD values (all P <0.05). Conclusions DTI can detect abnormalities of water molecules diffusion in normal spinal cord of patients with optic neuromyelitis and multiple sclerosis, and find out the difference of spinal diffusion index between them. It provides important information for early diagnosis and differential diagnosis.