中文摘要：

目的运用3．0TMRDTI技术探讨复发．缓解型多发性硬化（RRMS）患者及复发型视神经脊髓炎（RNMO）患者颈髓结构的改变，以及与临床评分的相关性。方法应用3．0TMR对30例RrtMS（MS组）、28例RNMO患者（NMO组）及20名健康志愿者（对照组）行颈髓DTI，分别测量（22～6颈髓中央灰质、右侧索、左侧索和后索等部位的平均扩散率（MD）和部分各向异性分数（FA），并对各测量值和扩展残疾状况量表（EDSS）评分进行相关性分析。统计学分析采用单因素方差分析及Spearman秩相关分析等。结果（1）3组间MD值在c3水平后索和左侧索、c4水平中央灰质和后索、C5～6水平各部位差异具有统计学意义（F值为4．006～36．814，P值均〈0．05），3组间FA值在各层面差异均具有统计学意义（F值为5．561～98．128，P值均〈0．05）。（2）MS组、NMO组和对照组丽两比较：MS组、NMO组较对照组MD值升高，FA值降低，差异有统计学意义（t值为-0．320～3．138，P值均〈0．05）；MS组和NMO组比较，MD值的差异无统计学意义（t值为-1．183～0．069，P值均〉0．05）；NMO组在C4水平中央灰质、后索、右侧索、左侧索FA值分别为0．57±0．09、0．56±0．11、0．54±0．10、0．57±0．09，C5水平分别为0．55±0．11、0．52±0．13、0．55±0．11、0．54±0．13，c6水平分别为0．54±0．10、0．54±0．11、0．53±0．13、0．52±0．11；相对应MS组C4水平FA值为0．67±0．10、0．68±0．10、0．68±0．10、0．70±0．12，C5水平为0．68±0．11、0．69±0．10、0．68±0．11、0．69±0．12，C6水平为0．67±0．14、0．68±0．15、0．69±0．14、0．69±0．16，两组间C4—6水平FA值差异均有统计学意义（t值为-0．011-0．169，P值均〈0．05）。（3）除c2及C4水平侧索外，其余各层面MD值同EDSS评分呈正相关（r值为0．324-0．541，P值均〈0．05），FA值同EDSS评分呈明显负相关（

英文摘要：

Objective To investigate the changes of the cervical spinal cord in patients with relapsing-remitting multiple sclerosis （RRMS） and relapsing neuromyelitis optica （RNMO） using diffusion tensor imaging （DTI） and to analyze its correlations with clinical disability scores. Methods Thirty patients with MS （MS group）, 28 patients with NMO （NMO group） and 20 healthy volunteers were imaged using DTI on a 3.0 Tesla scanner. DTI indices of cervical spinal cord from all participants were measured, including mean diffusivity （MD） and fractional anisotropy （FA）, and the correlations between the DTI metrics and the expanded disability status scale （EDSS） scores were assessed. One-way ANOVA, Dunnett-t test and Spearman correlation analysis were used for statistics. Results （ 1 ） The values of MD among three groups were different at C3 level for left lateral and dorsal columns, CA level for the central gray substanceand dorsal columns, and C5--C6 level for all structures. There were significant differences among them （F =4. 006-36. 814, P 〈 0. 05）. The values of FA were significantly different at all levels （F = 5. 561- 98. 128, P 〈0. 05）. （2） Compared with the control group, the values of MD were increased and FA were decreased for both MS and NMO groups, there were significant differences among them （ t = - 0. 320- 3. 138,P 〈0. 05）. In MS and NMO groups, there were no significant differences of MD （t = - 1. 183- 0. 069,P 〉 0. 05 ） , while the FA at CA-C6 levels （ including the central gray substance, dorsal columns, right lateral columns and left lateral columns ） for NMO group were 0. 57 ± 0. 09, 0. 56 ± 0. 11, 0. 54 ± 0. 10, 0.57 ±0.09, 0.55 ±0. 11,0.52 ±0. 13,0.55±0. 11,0.54 ±0. 13, 0.54 ±0. 10,0.54 ±0. 11, 0. 53 ±0. 13, 0. 52 ±0. 11 ;and for MS group were 0. 67 ±0. 10, 0. 68 ±0. 10, 0. 68 ±0. 10, 0. 70 ±0. 12, 0.68 ±0. 11,0.69±0. 10, 0.68 ±0. 11, 0.69 ±0. 12, 0.67 ±0. 14, 0.68 ±0. 15, 0.69 ±0. 14, 0.69 ＋ 0. 16, and there were sig