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目的比较多发性硬化(MS)患者脑内病灶、表现正常脑白质(NAWM)及健康志愿者脑白质的磁化传递及弥散特性的差异,探讨MS患者的磁化传递率(MTR)与平均弥散率(MD)的相关性。方法分别对24例复发缓解型MS患者和24名健康志愿者行常规MRI、磁化传递成像(MTI)及弥散张量成像(DTI),经处理后得到相应的MTR、MD及各向异性分数(FA)图。测量MS病灶、对侧NAWM及健康志愿者相应脑白质区域的MTR、MD及FA值。结果MS患者病灶的平均MTR值(23.49%±5.16%)明显低于NAWM组(29.49%±3.38%)及健康对照组(32.78%±3.42%,F=101.44,P<0.01);病灶的平均FA值(0.32±0.09)也明显低于NAWM组(0.42±0.09)及对照组(0.51±0.09,F=95.41,P<0.01);而病灶的平均MD值[(1.10±0.17)×10-3mm2/s]明显高于NAWM组[(0.92±0.13)×10-3mm2/s]及对照组[(0.76±0.04)×10-3mm2/s,F=144.89,P<0.01]。与MS患者T1WI等信号病灶相比,低信号病灶的MTR值及FA值降低,而MD值升高。MS患者病灶的MTR值与MD值显著相关,而NAWM的MTR与MD值无明显相关性。结论MTI和DTI的指标可以反映MS患者脑内不同部位病理变化的不同,为常规MRI提供补充信息。
Objective To compare the magnetization and diffusion characteristics of brain lesions in patients with multiple sclerosis (MS) with normal brain white matter (NAWM) and healthy volunteers, and to explore the relationship between magnetization transfer rate (MTR) and mean diffusivity MD). Methods Twenty-four patients with relapsing-remitting MS and 24 healthy volunteers underwent routine MRI, magnetic resonance imaging (MTI) and diffusion tensor imaging (DTI), respectively. The corresponding MTR, MD and anisotropy scores FA) map. The MTR, MD, and FA values of the corresponding white matter regions of MS lesions, contralateral NAWM and healthy volunteers were measured. Results The average MTR of lesions in MS patients was significantly lower than that in NAWM patients (29.49% ± 3.38%) and healthy controls (32.78% ± 3.42%, F = 101.44, P <0.01) FA value was significantly lower than that in NAWM group (0.42 ± 0.09) and control group (0.51 ± 0.09, F = 95.41, P <0.01), while the mean FA value was (1.10 ± 0.17) × 10- 3mm2 / s] was significantly higher than that of NAWM group [(0.92 ± 0.13) × 10-3mm2 / s] and control group [(0.76 ± 0.04) × 10-3mm2 / s, F = 144.89, P <0.01]. Compared with T1WI and other signal lesions in MS patients, the MTR value and FA value of low signal lesion decreased, while the MD value increased. There was a significant correlation between MTR values and MD values in patients with MS, but no significant correlation between MTR and MD values in NAWM patients. Conclusion The indexes of MTI and DTI can reflect the different pathological changes in different parts of brain in patients with MS, providing additional information for conventional MRI.