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目的利用扩散张量成像(DTI)直方图分析,明确复发好转型多发性硬化(RRMS)常规MRI表现正常脑组织(NABT)是否存在隐匿性损伤,并研究NABT的DTI直方图指标与扩展残疾状态(EDSS)评分、病程、T2WI病灶体积及脑组织体积的相关性。方法对24例RRMS患者和24例性别和年龄匹配的正常志愿者行常规MRI和DTI检查,分割提取NABT后,得到NABT的平均弥散率(MD)和部分各向异性(FA)直方图并对其进行分析。结果RRMS患者NABT的平均MD为1.014×10-3mm2·s-1、MD直方图峰位置为0.809×10-3mm2·s-1和FA直方图峰高为4.502‰明显高于正常志愿者(分别为0.910×10-3mm2·s-1、0.767×10-3mm2·s-1和4.107‰)(P<0.001),而MD直方图峰高为8.858‰和平均FA为0.231明显低于正常志愿者(0.767‰和0.254)(P<0.001)。在RRMS患者,所有NABT的MD和FA直方图指标与EDSS评分和病程均无相关性,但多数指标与T2WI病灶体积及脑组织体积显著相关。结论RRMS患者NABT内存在隐匿性损伤,其损伤程度与脑内病灶负荷及脑萎缩程度有关。
OBJECTIVE: To determine if occult lesions exist in normal brain tissue (NABT) with routine MRI of recurrent multiple sclerosis (RRMS) using diffusion tensor imaging (DTI) histogram analysis and to investigate the relationship between DTI histogram index and extended disability status of NABT (EDSS) score, duration of disease, volume of T2WI lesions and brain tissue volume. Methods Twenty-four patients with RRMS and 24 normal and age-matched normal volunteers underwent routine MRI and DTI examinations. After NABT was extracted and divided, the mean diffusivity (MD) and partial anisotropy (FA) histograms of NABT were obtained and compared It is analyzed. Results The mean MD of NABT in RRMS was 1.014 × 10-3mm2 · s-1, the peak position of histogram in MD was 0.809 × 10-3mm2 · s-1 and the peak height of FA histogram was 4.502 ‰, which was significantly higher than that of normal volunteers (0.910 × 10-3mm2 · s-1, 0.767 × 10-3mm2 · s-1 and 4.107% o) (P <0.001), while the histogram of MD was 8.858 ‰ and the average FA was 0.231, which was significantly lower than that of normal volunteers (0.767 ‰ and 0.254) (P <0.001). In RRMS patients, all NABT MD and FA histograms had no correlation with EDSS scores and duration, but most of the markers were significantly associated with T2WI lesions volume and brain volume. Conclusions There is occult damage in NABT in RRMS patients, and the degree of damage is related to the severity of brain lesions and brain atrophy.