3.0T磁共振在脑白质疏松症及多发性硬化鉴别诊断中应用分析
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摘要
目的:探讨3.0T磁共振(MedicalResonanceImagin,MRI)在脑白质疏松症(Leukoaraiosis,LA)及多发性硬化(MultipleSclerosis,MS)鉴别诊断中的应用效果。方法:选择医院确诊的42例MS和64例LA患者,均采用常规3.0TMRI与弥散张量成像(Diffusiontensorimaging,DTI)检查,比较MS与LA患者的PVH分型以及不同分型FA值与ADC值的变化情况,分析PVH分级1型中不同部位脑白质病灶FA值与ADC值的差异。结果:LA组PVH分型较MS组严重,差异有统计学意义(P<0.05);PVH分级越高,MS与LA的表观扩散系数(Apparentdiffusioncoefficient,ADC)值呈逐渐增高趋势(r=0.641、0.785,P=0.002、0.000),部分各向异性(Fractionanisotropy,FA)值呈逐渐降低趋势(r=-0.415、-0.582,P=0.005、0.006);PVH分级1型中LA组侧脑室后角周围白质区、侧脑室前角周围白质区、放射冠FA值以及放射冠ADC值均低于MS组,差异具有统计学意义(P<0.05);LA组侧脑室后角周围白质区、侧脑室前角周围白质区ADC值低于MS组,差异无统计学意义(P>0.05)。结论:3.0TMRIDTI检查可较为准确的鉴别早期LA与MS病灶,为临床早期诊治MS提供参考依据。
Objective: To investigate the application of 3.0 T magnetic resonance( Medical Resonance Imagin, MRI)in the differential diagnosis of leukoaraiosis( Leukoaraiosis, LA) and multiple sclerosis(Multiple Sclerosis, MS).Methods: 42 patients with MS and 64 LA patients diagnosed were examined by routine 3 TMRI and diffuse tensor imaging(Diffusion tensor imaging, DTI). The changes of PVH sub-types of MS and LA patients and the changes of FA values and ADC values were compared. The difference between the value and the ADC value. Results: The PVH classification in group LA was more serious than that in group MS, and the difference was statistically significant(P<0.05).The higher the PVH classification, the apparent diffusion coefficient(Apparent diffusion coefficient, ADC) of MS and LA increased gradually(r=0.641, 0.785, 0), and the value of partial anisotropy decreased gradually. The potential(r=-0.415,-0.582, P=0.005, 0.006), the white matter around the posterior horn of the lateral ventricle, the white matter around the anterior horn of the lateral ventricle, the FA value of the radiated crown and the ADC value of the radiation crown in the LA group of the LA group were lower than those in the MS group, and the difference was statistically significant(P<0.05); the peripheral ventricle around the lateral ventricle and the white matter around the lateral ventricle of the lateral ventricle of the LA group were in the white matter area. The ADC value was lower than that of MS group, and the difference was not statistically significant(P>0.05). Conclusion: 3.0 T MRI DTI examination can accurately identify early LA and MS lesions, and provide reference for early diagnosis and treatment of MS.
Objective: To investigate the application of 3.0 T magnetic resonance( Medical Resonance Imagin, MRI)in the differential diagnosis of leukoaraiosis( Leukoaraiosis, LA) and multiple sclerosis(Multiple Sclerosis, MS).Methods: 42 patients with MS and 64 LA patients diagnosed were examined by routine 3 TMRI and diffuse tensor imaging(Diffusion tensor imaging, DTI). The changes of PVH sub-types of MS and LA patients and the changes of FA values and ADC values were compared. The difference between the value and the ADC value. Results: The PVH classification in group LA was more serious than that in group MS, and the difference was statistically significant(P<0.05).The higher the PVH classification, the apparent diffusion coefficient(Apparent diffusion coefficient, ADC) of MS and LA increased gradually(r=0.641, 0.785, 0), and the value of partial anisotropy decreased gradually. The potential(r=-0.415,-0.582, P=0.005, 0.006), the white matter around the posterior horn of the lateral ventricle, the white matter around the anterior horn of the lateral ventricle, the FA value of the radiated crown and the ADC value of the radiation crown in the LA group of the LA group were lower than those in the MS group, and the difference was statistically significant(P<0.05); the peripheral ventricle around the lateral ventricle and the white matter around the lateral ventricle of the lateral ventricle of the LA group were in the white matter area. The ADC value was lower than that of MS group, and the difference was not statistically significant(P>0.05). Conclusion: 3.0 T MRI DTI examination can accurately identify early LA and MS lesions, and provide reference for early diagnosis and treatment of MS.
引文
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[9]王宇鸣,邹海波,李中实.磁共振弥散张量成像技术在颈椎外科应用的研究进展[J].中国脊柱脊髓杂志,2017,27(6):561-565.
[10]邓忠勇,谢锦兰.磁共振弥散张量成像在神经外科系统疾病应用进展(综述)[J].安徽卫生职业技术学院学报,2016,15(6):51-52,54
[2]芮文婷,姚振威.多发性硬化的MRI研究进展[J].国际医学放射学杂志,2018,41(1):27-31.
[3]何浪,赵路清,邵宏元,等.脑白质疏松症患者早期认知功能损害与弥散张量成像的相关性研究[J].中华神经医学杂志,2017,16(12):1235-1241.
[4]韩雪梅,郑昭时,刘颖,等.多发性硬化核磁共振深部灰质铁沉积的研究及与临床相关性探讨[J].中国实验诊断学,2017,21(12):2165-2167.
[5]李海峰.多发性硬化的诊断标准2010年修订版简介[J]中国神经免疫学和神经病学杂志,2011,18(3):226-227.
[6]蔡志友,尤志珺,涂汉军.脑白质疏松症的诊断和鉴别诊断[J].湖北医药学院学报,34(5):423-426.
[7]高薇薇,薛蓉,程焱.脑梗死及白质病变临床分型与血管性认知功能障碍的相关性[J].中华神经科杂志,2012,45(5):318-322.
[8]李越秀,王金芳,沈慧聪,等.脑白质疏松症伴轻度认知损害患者静息态功能磁共振成像研究[J].中国现代神经疾病杂志,2016,16(5):264-270.
[9]王宇鸣,邹海波,李中实.磁共振弥散张量成像技术在颈椎外科应用的研究进展[J].中国脊柱脊髓杂志,2017,27(6):561-565.
[10]邓忠勇,谢锦兰.磁共振弥散张量成像在神经外科系统疾病应用进展(综述)[J].安徽卫生职业技术学院学报,2016,15(6):51-52,54