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目的利用扩散张量纤维束成像(DTT)定量研究复发-好转型多发性硬化(RRMS)患者的皮质脊髓束分数各向异性(FA)值与正常志愿者之间的差异及其与扩展病残状态评分(EDSS)的相关性。方法对36例正常志愿者和64例RRMS患者进行扩散张量成像检查,重组出皮质脊髓束,计算出该纤维束的平均FA值,比较RRMS组与对照组之间是否存在差异,研究该指标与EDSS和锥体束评分的相关性。结果正常志愿者的皮质脊髓束FA值(男:0.501±0.026,女:0.493±0.024,左侧:0.500±0.031,右侧:0.494±0.024),无性别和侧别差异(P值均>0.05)。RRMS患者皮质脊髓束的FA值(0.472±0.037)明显低于对照组(0.497±0.028),差异有统计学意义(P<0.01)。脑型(0.469±0.038)与脊髓型(0.476±0.035)RRMS患者的皮质脊髓束FA值之间差异无统计学意义(P>0.05)。RRMS患者皮质脊髓束FA值与EDSS(平均3.0分)(r=-0.193,P<0.05)和锥体束评分(平均2.0分)(r=-0.218,P<0.05)存在弱相关性,其中,脑型患者的皮质脊髓束FA值与EDSS(平均3.1分)(r=-0.273,P<0.05)和锥体束评分(平均2.1分)(r=-0.268,P<0.05)的相关性较高,而在脊髓型患者的皮质脊髓束FA值与EDSS(平均2.8分)和锥体束评分(平均1.9分)均无显著相关性(r值分别为-0.080和-0.115,P值均>0.05)。结论RRMS患者皮质脊髓束的FA值存在明显异常,该指标可用作评价脑型RRMS患者的临床功能状态。
Objective To quantitatively study the difference of fractional anisotropy of corticospinal tract fractional anisotropy (FA) between patients with recurrent and benign multiple sclerosis (RRMS) and normal volunteers by diffusion tensor tractography (DTT) Status score (EDSS) relevance. Methods Thirty-six normal volunteers and 64 patients with RRMS were examined by diffusion tensor imaging, and the cortical spinal cord was reconstructed to calculate the average FA value of the fiber bundle. The differences between the RRMS group and the control group were compared. Correlation with EDSS and cone beam score. Results The FA value of corticospinal tract in normal volunteers (male: 0.501 ± 0.026, female: 0.493 ± 0.024, left: 0.500 ± 0.031, right: 0.494 ± 0.024) ). The FA value of corticospinal tract of RRMS patients (0.472 ± 0.037) was significantly lower than that of the control group (0.497 ± 0.028), the difference was statistically significant (P <0.01). There was no significant difference in FA value of corticospinal tract between cerebral (0.469 ± 0.038) and spinal (0.476 ± 0.035) RRMS patients (P> 0.05). There was a weak correlation between the FA value of corticospinal tract of RRMS patients and EDSS (average 3.0) (r = -0.193, P <0.05) and pyramidal tract score (average 2.0) (r = -0.218, P <0.05) , The correlation between the FA value of corticospinal tract of brain patients and EDSS (average 3.1) (r = -0.273, P <0.05) and pyramidal tract score (average 2.1) (r = -0.268, P <0.05) , While FA values of corticospinal tract in patients with spinal cord type had no significant correlation with EDSS (average 2.8 points) and pyramidal tract score (average 1.9 points) (r values were -0.080 and -0.115 respectively, P values > 0.05). Conclusions There is a significant abnormal FA value in corticospinal tract of patients with RRMS. This index can be used to evaluate the clinical functional status of RRMS patients.