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目的探讨三维增强T_2*加权血管成像(ESWAN)相位值(phase)及有效横向弛豫率值(R_2*)对多发性硬化(MS)患者深部灰质核团铁沉积的诊断价值,并分析测量值与扩展型残疾状态评分(EDSS)、病程相关性。方法22例临床确诊MS患者及与之性别、年龄及教育程度相匹配的22名健康对照组行常规MRI和ESWAN扫描。测量患者及对照组深部灰质核团(双侧丘脑、尾状核头、壳核、苍白球、红核、黑质)phase值及R_2*值。详细记录每例患者病程时间及EDSS评分。结果 (1)MS患者双侧深部灰质核团phase值均低于对照组,其中双侧尾状核头、壳核、红核及黑质与对照组比较差异具有统计学意义(P<0.05)。(2)MS患者双侧各个灰质核团R_2*均高于对照组,差异均具有统计学意义(P<0.05)。(3)MS患者各深部灰质核团phase值、R_2*值与EDSS评分、临床病程均无明显相关性(P>0.05)。结论 ESWAN序列多种测量值均能定量显示MS患者脑深部灰质核团明显铁质含量增多,有助于了解MS病理机制、研究颅内铁沉积与患者临床表现的相关性。
Objective To investigate the diagnostic value of ESWAN phase and effective transverse relaxation rate (R_2 *) in the diagnosis of deep gray matter iron deposition in patients with multiple sclerosis (MS) And extended disability status score (EDSS), duration of disease. Methods Twenty-two healthy subjects with MS diagnosed clinically and matched with their gender, age and educational level underwent routine MRI and ESWAN scan. The phase values and R 2 * values of deep gray matter nuclei (bilateral thalamic nucleus, caudate nucleus, putamen, globus pallidus, red nucleus and substantia nigra) in patients and controls were measured. Detailed records of each patient duration and EDSS score. Results (1) The phase values of bilateral deep gray matter nuclei in MS patients were lower than those in the control group. There were significant differences in the bilateral caudate nucleus, putamen, red nucleus and substantia nigra compared with the control group (P <0.05) . (2) The R_2 * of each gray matter nucleus on both sides of MS patients were higher than that of the control group, the differences were statistically significant (P <0.05). (3) There was no significant correlation between R value and EDSS score and clinical course of MS patients (P> 0.05). Conclusion Various ESWAN measurements can quantitatively show the significant increase of iron content in brain deep gray matter nuclei in MS patients. It is helpful to understand the pathological mechanism of MS and to study the correlation between intracranial iron deposition and clinical manifestations.