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目的探讨肌萎缩侧索硬化症(amyotrophic lateral sclerosis,ALS)锥体束和非锥体束区域的磁化传递成像(magnetization transfer imaging,MTI)特点以及锥体束的磁化传递率(MTR)与临床表现、常规MRI征象的关系。资料与方法对20例ALS患者及16名健康自愿者(对照组)行常规头颅MRI及MTI。测量锥体束区5个位置及非锥体束区3个位置的MTR值。结果确诊组ALS在锥体束5个位置上的MTR值均显著低于对照组(P<0.01);疑似组ALS在其中3个位置上显著低于对照组(P<0.01)。确诊组ALS在胼胝体膝部的MTR值显著低于对照组(P<0.05)。患者组锥体束5个位置的MTR值与ALSFRS评分及病程间均无相关性。结论 MTI是诊断ALS有效且敏感的检查方法 ,ALS存在锥体束以外脑组织的变性改变。
Objective To investigate the characteristics of magnetization transfer imaging (MTI) in pyramidal tract and non-pyramidal tract of amyotrophic lateral sclerosis (ALS) and the relationship between the MTR and clinical manifestations , The relationship between conventional MRI signs. Materials and Methods 20 patients with ALS and 16 healthy volunteers (control group) underwent routine cranial MRI and MTI. The MTR values were measured at 5 locations in pyramidal tract and 3 locations in non-pyramidal tract. Results The MTR value of ALS in 5 positions of pyramidal tract was significantly lower in the diagnosed group than in the control group (P <0.01). ALS in the suspected group was significantly lower than that in the control group at 3 positions (P <0.01). The MTR value of ALS in the corpus callosum knee in the diagnosed group was significantly lower than that in the control group (P <0.05). There was no correlation between the MTR value of 5 positions in pyramidal tract of patients and ALSFRS score and duration of disease. Conclusions MTI is an effective and sensitive method for the diagnosis of ALS. There is degeneration of brain tissue in ALS.