中文摘要：

目的 应用基于体素的形态测量研究技术,分析复发缓解型多发性硬化（RRMS）患者脑形态学变化,探讨其与临床参数的相关性.方法 选取RRMS患者21例,性别、年龄相对应的健康对照组21例.采用西门子3.0T MR扫描仪,行常规MR扫描及3D-T1WI扫描.应用DARTEL优化的VBM8,采用SPM8两样本t检验,计算全脑灰白质萎缩区域,患者扩展残疾状态量表（EDSS）、节奏听觉连续加法测试评分（PASAT）及经过修正的疲劳影响尺度（MFIS）与脑实质分数（BPF）、脑萎缩区域体积的相关性使用SPSS软件Pearson相关分析进行统计.结果 与对照组比较,RRMS患者BPF减低[（83.0±2.1）% vs （84.9±1.4）%）,t=-3.361,P=0.002],灰质萎缩主要分布在双侧丘脑、双侧壳核（右侧较左侧明显）、左侧豆状核、左侧颞叶、右侧枕叶（P＆lt;0.001,cluster＆gt;50）,白质萎缩主要为双侧额叶、颞叶（P＆lt;0.001,cluster＆gt;50）.区域性脑萎缩以丘脑萎缩最明显,且丘脑体积与EDSS、MFIS评分呈负相关（r=-0.475,P=0.001;r=-0.519,P＆lt;0.001）,与PASAT评分呈正相关（r=0.311,P=0.045）.结论 RRMS患者存在广泛的脑萎缩,其中丘脑萎缩最为明显,且与临床有相关性,故丘脑萎缩可作为临床疾病进展的预测指标之一.

英文摘要：

Objective To analyze the morphological changes of the brain in relapsing remitting multiple sclerosis （RRMS） patients applied by voxebbased morphology （VBM） ,and to explore its relationship witb clinical parameters. Methods 21 patients with RRMS and 21 sex- and age matched beahhy controls were recruited in the study. Routine and 3D-T1 WI images were obtained from the Siemens 3.0T MR system. The atrophy area of whole brain gray matter was calculated by the optimized VBM8 analysis using DARTEL, and SPM8 software was used to perform two sample t test. The correlation between Expanded Disability Status Scale （EI）SS）,Paced Auditory Serial Addition Test （PASAT）, Modified Fatigue Impact Scale （MFIS） and brain parenchymal fraction （BPF） as well as the volume of brain atrophy area were analyzed by Pearson correlation analysis using SPSS software. Results Compared to the control group, the RRMS patients showed decreased BPF [-（83.0±2. 1）% vs （84.9±1.4）%） , t=--3. 361, P= 0. 002], the atrophy of grey matter were mostly located in bilateral thalamus and putamen （the right side was more obvious than the left） ,left lenticular nucleus,left temporal lobe and right occipital lobe （P〈0. 001 , cluster〉50） , while the atrophy of white matter were mainly in bilateral frontal and temporal lobe （P〈0.001,cluster〉50）. Thetbalamus was the most obvious atrophy area among regional brain atrophy. The thalamus volume showed negative correlation with EDSS and MFIS scoring （r= 0. 475, P 0. 001 ; r=0.519, P〈0.001）, and displayed positive correlation with PASAT scoring （r=0. 311, P=0.045）. Conclusion RRMS patients widely have brain atrophy, among which the thalamus atrophy is the most obvious one and correlated with clinical results. Hence, thalamus atrophy may serve as a predictor of clinical disease progression.