目的应用扩散张量成像(DTI)技术探讨复发-缓解型多发性硬化(RRMS)患者视力损伤与双侧视放射白质纤维束损伤的相关性。方法选取视力损伤的RRMS患者(患者组)及年龄与性别相匹配的健康志愿者(对照组)各25例行DTI检查,分别测量双侧视放射的FA值及MD值,采用扩展残疾状态量表(EDSS)对患者进行评分。分析患者组与对照组组内及组间两侧视放射的FA值及MD值差异,以及与EDSS评分的相关性。结果 1对照组及患者组组内双侧视放射FA值(t=0.41,P=0.68;t=0.09,P=0.92)及MD值(t=0.72,P=0.48;t=0.20,P=0.84)差异均无统计学意义;患者组左右侧视放射FA值(t=8.29,P〈0.01;t=8.42,P〈0.01)均较对照组下降,MD值(t=7.17,P〈0.01;t=6.58,P〈0.01)均高于对照组;2左右侧视放射FA值(r=-0.24,P=0.30;r=-0.13,P=0.58)及MD值(r=0.16,P=0.50;r=0.31,P=0.19)与EDSS评分无明显相关性。结论 RRMS患者视力受损与双侧视放射的白质纤维束损害具有一定的关系。
Objective To explore the correlation between visual impairment and white matter fiber bundle damage of bilateral optic radiation in patients with relapsing-remitting multiple sclerosis(RRMS)by diffusion tensor imaging(DTI).Methods Totally 25 RRMS patients with visual impairment(RRMS group)and 25 cases age-and sex-matched healthy volunteers(control group)underwent DTI.The fractional anisotropy(FA)and mean diffusivity(MD)of bilateral optic radiation were measured,and all RRMS patients were evaluated by the expanded disability status scale(EDSS).The FA value and MD value were compared between two groups and two sides of each group,then the correlation with EDSS were analyzed.Results 1The FA value(t=0.41,P=0.68;t=0.09,P=0.92)and MD value(t=0.72,P=0.48;t=0.20,P=0.84)of bilateral optic radiation in RRMS group and control group had not significant difference,respectively.The FA values of left and right optic radiation were significantly decreased than that of the control group(t=8.29,P〈0.01;t=8.42,P〈0.01),while the MD values were significantly higher than that of the control group(t=7.17,P〈0.01;t=6.58,P〈0.01).2There were no correlation between both FA values(r=-0.24,P=0.30;r=-0.13,P=0.58)and MD values(r=0.16,P=0.50;r=0.31,P=0.19)of bilateral optic radiation and EDSS scores.Conclusion There is some correlation between the white matter fiber bundle damage in the bilateral optic radiation and the visual impairment in patients with RRMS.