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目的应用静息态功能磁共振(RS-f MRI)局部一致性(Re Ho)技术,探讨仅有脊髓受累型多发性硬化患者(MS-SSCI)血氧水平依赖信号的Re Ho。方法对23例MS-SSCI患者(MS-SSCI组)及23名年龄、性别相匹配的健康志愿者(对照组)进行RS-f MRI扫描,比较两组间Re Ho改变的脑区,进一步分析MS-SSCI患者Re Ho值与临床扩展残疾状态量表(EDSS)评分及病程间的相关性。结果与对照组相比,MS-SSCI患者左侧小脑脚Ⅱ、双侧颞中回、左侧纺锤体、左侧中央前回、右侧辅助运动区的Re Ho明显降低;左侧小脑Ⅸ区、双侧尾状核、左侧后扣带回的Re Ho明显升高(双样本t检验,经Alpha Sim校正,P<0.01,体素大小>40)。相关性分析结果显示,MS-SSCI患者左侧后扣带回Re Ho值和EDSS呈正相关(r=0.586,P=0.003)。结论 MS-SSCI患者静息状态下存在局部脑功能异常,且功能异常与临床残疾状况密切相关,RS-f MRI在探测MS-SSCI脑内潜在性病变方面具有重要价值。
Objective To investigate Re Ho of patients with spinal cord-involved multiple sclerosis (MS-SSCI) with oxygen level dependent signal only by using Re Ho technique of resting state functional magnetic resonance (RS-f MRI). Methods Twenty-three MS-SSCI patients (MS-SSCI group) and 23 healthy volunteers (control group) matched with age and sex were scanned by RS-f MRI. Re Ho changed brain regions were compared between the two groups for further analysis Correlation between Re Ho value and clinical extended disability status scale (EDSS) scores and course of disease in patients with MS-SSCI. Results Compared with the control group, the Re Ho of the left cerebellum foot Ⅱ, bilateral middle temporal gyrus, left spindle, left middle anterior gyrus and right lateral gyrus of MS-SSCI patients decreased significantly. Compared with the control group, Re Ho was significantly increased in the bilateral caudate nucleus and posterior cingulate gyrus (two-sample t-test, adjusted by Alpha Sim, P <0.01, voxel size> 40). Correlation analysis showed that there was a positive correlation between Re Ho value and EDSS in the left atria of patients with MS-SSCI (r = 0.586, P = 0.003). Conclusion There is a local brain dysfunction in MS-SSCI patients at rest, and the abnormal function is closely related to clinical disability. RS-f MRI is of great value in detecting potential brain lesions in MS-SSCI.