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目的运用3.0 T MR扩散张量成像(DTI)技术探讨复发-缓解型多发性硬化(RRMS)和复发型视神经脊髓炎(RNMO)患者脑深部核团的DTI指标是否存在差异,以及该指标与临床残疾评分(EDSS)是否存在相关性。方法用3.0 T MR分别对RRMS患者(MS组)、RNMO患者(NMO组)及健康志愿者(对照组)各30名进行脑部DTI扫描,分别测量脑深部核团的平均扩散率(MD)和部分各向异性分数(FA),并分析所得结果与临床评分的相关性。统计学分析采用单因素方差分析、Dunnett-t检验、Spearman相关分析、配对t检验等。结果 (1)MS组与对照组比较:前者丘脑(t=0.239,P=0.002)和黑质(t=0.667,P=0.016)的MD值升高,苍白球(t=-0.057,P=0.002)和齿状核(t=-0.052,P=0.012)的FA值降低;NMO组与对照组比较:前者红核的MD值升高(t=-0.034,P=0.034),差异有统计学意义;MS组与NMO组比较,两者壳核的FA值差异显著(t=-0.339,P=0.034)。(2)分析各指标同EDSS评分的相关性,结果 EDSS评分与丘脑(r=0.26,P=0.045)和黑质(r=0.329,P=0.01)MD值呈正相关,与FA值无显著相关性(P>0.05)。结论 MS和NMO患者灰质均有受累,壳核对鉴别MS与NMO具有潜在的应用价值,其FA值可作为监测MS及NMO临床进展的重要生物学指标。
Objective To investigate the difference of DTI index in deep brain nuclei in patients with relapsing-remitting multiple sclerosis (RRMS) and recurrent optic neuromyelitis (RNMO) using 3.0 T MR diffusion tensor imaging (DTI) Disability score (EDSS) whether there is correlation. Methods Thirty DMRs were obtained from 30 RRMS patients (MS group), RNMO patients (NMO group) and healthy volunteers (control group) respectively by 3.0 T MR. The mean diffusivity (MD) And partial anisotropy (FA), and analyze the correlation between the results and clinical scores. Statistical analysis using one-way ANOVA, Dunnett-t test, Spearman correlation analysis, paired t test. Results Compared with the control group, the MD value of the thalamus (t = -0.057, P = 0.002) and substantia nigra (t = 0.667, 0.002) and odontoid nucleus (t = -0.052, P = 0.012). Compared with the control group, the FA value of NMO group increased: the MD value of the former red nucleus increased (t = -0.034, P = 0.034) The significance of FA in the putamen between MS group and NMO group was significant (t = -0.339, P = 0.034). (2) The correlation between each index and EDSS score was analyzed. Results The EDSS score was positively correlated with MD of thalamus (r = 0.26, P = 0.045) and substantia nigra (r = 0.329, P = 0.01), but not with FA (P> 0.05). Conclusion The gray matter of MS and NMO patients are all involved. The putamen can be used to differentiate MS from NMO. The FA value can be used as an important biological indicator to monitor the clinical progress of MS and NMO.