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在多发性硬化症早期阶段弥散张量MrI检测到的正常表现白质的损害与疾病短期内的活动度无关

世界核心医学期刊文摘（神经病学分册） 2005年第9期1卷 23-24页

作者： Gallo A. rovaris M. riva r.etal. M. Filippi 江山 Department of Neurology Scientific Institute University Ospedale San Raffaele Via Olgettina 60 20132 Milan ItalyDr.

Background: Diffusion-tensor (DT) magnetic resonance imaging (MrI) has the po tential to elucidate some characteristics of tissue microstructure inaccessible to other MrI techniques. Objective: To investigate whether normal-appearing bra in tissue abnormalities occur in patients with multiple sclerosis at the earlies t clinical stage and whether their severity is predictive of a short-term disea se evolution by using DT MrI. Design: Forty-five patients and 22 healthy contro l subjects were studied. All patients had had a clinically isolated syndrome wit hin the 3 months preceding study enrollment and paraclinical evidence of disease dissemination in space. During a single session, dual-echo, pulsed-gradient s pin-echo echo-planar, and postgadolinium T1-weighted images of the brain were obtained from each subject. In patients, dual-echo and enhanced images were ob tained after 3 and 12 months, to detect MrI signs of disease dissemination in ti me. An on-study neurological examination was also conducted to ascertain the oc currence of clinical relapses. Mean diffusivity and fractional anisotropy maps w ere derived from DT images. Normal-appearing white matter (N-AWM) and normal- appearing gray matter mean diffusivity and fractional anisotropy histograms were produced and analyzed. results: During the study period, 29 patients showed MrI evidence of disease dissemination in time. When compared with healthy controls, patients showed higher average NAWM mean diffusivity (P=.01), lower average NAW M mean diffusivity peak height (P ractional anisotropy (P rI characteristics of patients did not differ between those with and those without disease dissemina tion in time at follow-up. Conclusions: In patients with multiple sclerosis at the earliest clinical stage, the severity of NAWM damage does not predict new le sion formation in the short term, suggesting that the “diffuse”component of ti ssue damage is, at least partially, independent of the

关键词：多发性硬化症 MrI检测弥散张量临床综合征平均弥散度双折射度单次治疗亚临床微观结构特征复发率

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