Multipl sklerozlu hastalarda perfüzyon ağırlıklı manyetik rezonans görüntüleme bulguları ve klinik testler ile ilişkisi

Amaç: Perfüzyon ağırlıklı manyetik rezonans görüntüleme, santral sinir sisteminin mikrovasküler dolaşımını değerlendirmek için kullanılan yeni bir tekniktir. Bu çalışmamızda nörolojik defisite sahip multipl skleroz hastalarını perfüzyon görüntüleme ile değerlendirmeyi ve elde edilen değerleri kontrol grubu ile karşılaştırmayı amaçladık. Gereç ve Yöntem: Ataklarla seyreden 25 multipl skleroz hastası ve 25 yaş/cinsiyet eşleştirmeli kontrol grubu çalışmaya dâhil edildi. Tüm hastalara klinik testler uygulandı ve takip eden 48 saat içerisinde perfüzyon ağırlıklı manyetik rezonans görüntüleme yapıldı. Bulgular: Periventriküler normal beyaz cevherden elde edilen hasta ve kontrol grubuna ait perfüzyon verilerinin karşılaştırılmasında, serebral kan hacmi haritasından elde edilen perfüzyon değerlerinde her iki grup arasında anlamlı fark izlenirken (p

Objective: Perfusion-weighted magnetic resonance imaging is recently used for the assessment of the microvascular circulation of the CNS. In this study, we aim to evaluate multiple sclerosis patients with neurologic disability using perfusion MRI and compare the perfusion parameters of those with controls. This study also aims to demonstrate any possible correlations between these parameters and clinical scales which assess the progression of the disease. Material and Methods: Twenty-five consecutive patients with relapsing-remitting MS and 25 age and gender-matched controls were selected. All patients were subjected to clinical scales and perfusion MRI was performed in all patients within the next 48 hours after the clinical scales were concluded. Results: Significant difference were observed between patient group and controls regarding the periventricular normal-appearing white matter perfusion values extracted from CBV maps (p< 0.01). There were not any significant differences found between two groups by means of perfusion values extracted from other maps. There was not any statistically significant correlation found between clinical scales and perfusion values. Conclusion: White matter in MS patients have reduced perfusion compared to healthy subjects. We think that these changes are due to the reduced capillary volume which is associated with MS pathogenesis. Lack of association between perfusion values and clinical scales suggests perfusion MRI has not been useful in the determination of neurologic disability in MS patients yet.

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