目的 应用三维(3D)增强型T2*加权血管成像(ESWAN)技术观察复发-缓解型多发性硬化(RRMS)患者中央前回灰质铁沉积的动态变化及其与中央前回体积和临床相关参数的相关性.方法 选取RRMS患者30例,间隔1年进行两次常规MR、轴位3D T1W及 ESWAN扫描,测量中央前回灰质铁沉积,以平均相位值(MPVs)表示;比较两次中央前回灰质MPVs值和中央前回体积的变化,分析中央前回MPVs值与中央前回体积、临床EDSS评分及病程的相关性.结果 两次检查中,中央前回灰质MPVs值分别为(2033.13±14.39)和(2022.65±17.94),差异有统计学意义(P〈0.05);中央前回体积分别为(2307.82±109.24)和(2216.82±118.70)mm3,差异无统计学意义(P〉0.05);中央前回灰质MPVs与中央前回体积均呈正相关(rs=0.764、0.592,P均〈0.05); 中央前回灰质MPVs差值与中央前回体积差值呈正相关(rs=0.582,P〈0.05).两次EDSS评分差值与中央前回体积差值呈负相关(rs=-0.587,P〈0.05),与两次中央前回灰质MPVs差值无相关性(P〉0.05);病程与中央前回灰质MPVs值呈负相关(rs=-0.399,P〈0.05);复发次数与两次MPVs差值呈负相关(rs=-0.367,P〈0.05).结论 RRMS患者中央前回灰质铁异常沉积随病程进展而增加.
Objective To observe the dynamic change of iron deposition in the precentral gray matter and its correlation with the volume of precentral gray matter and related clinical parameters in patients with relapse-remitting multiple sclerosis (RRMS) by using three demensional (3D) enhanced T2* weighted angiography (ESWAN). Methods Thirty patients with RRMS were recruited and underwent conventional MR, ESWAN and 3D T1W scanning twice with the interval of one year. The mean phase values (MPVs) representing iron deposition and the volumes of precentral gray matter were measured. The correlation between iron deposition in the precentral gray matter with the volume of precentral gray matter, expended disability status scale (EDSS) sores and duration of disease were analyzed. Results In the two measurements, the precentral gray matter MPVs were (2033.13±14.39) and (2022.65±17.94), respectively (P〈0.05), and the volumes of the precentral gray matter were (2307.82±109.24) and (2216.82±118.70) mm3, respectively (P〉0.05). There was significant positive correlation between MPVs and the volume of precentral gray matter in both two measurements (rs=0.764, 0.592, both P〈0.05), as well as between the change of MPVs and of precentral gray matter volume (rs=0582, P〈0.05). The change of EDSS had significant negative correlation with the change of precentral gray matter volume(rs=-0.587, P〈0.05), but not with the change of MPVs (P〉0.05). There was negative correlation between duration of disease and MPVs (rs=-0.399, P〈0.05), as well as between the recurrence rate and the change of MPVs (rs=-0.367, P〈0.05). Conclusion The iron deposition in precentral gray matter increases with the disease progression in patients with RRMS.