Diffusion Tensor Imaging Findings In Relapsing Remitting Multiple Sclerosis Patients: A Case Control Study

GİRİŞ ve AMAÇ: Bu çalışmada, Multiple Skleroz (MS) hastalarında çeşitli normal görünen beyin anatomik lokalizasyonların Difuzyon Tensor Görüntüleme (DTG) bulgularını incelemek amaçlanmıştır. Ek olarak, MS hastalarında yapısal, fonksiyonel ve klinik hasarı yorumlamak için beyaz ve gri cevherin hacimsel analizi ve bu bulguların Genişletilmiş Özürlülük Durumu Ölçeği (Expanded Disability Status Scale; EDSS) ile korelasyonu yapıldı. YÖNTEM ve GEREÇLER: Çalışmamıza McDonald 2010 kriterlerine göre tanı almış 32 relapsing remitting MS hastası ve 24 sağlıklı kontrol dahil edildi. Hasta ve kontrol grubuna 3T DTG-traktografi ve volumetrik Manyetik rezonans görüntüleme (MRG) ile hasta grubuna rutin kranial MRG incelemesi yapıldı. Çeşitli anatomik alanlardan traktografi ölçümlerinden ortalama difüzyon (MD) ve fraksiyonel anisotropi (FA) değerleri kaydedildi. MS hastalarının EDSS skorları kaydedildi ve DTI parametreleri ve volumetrik analiz ile korele edildi. BULGULAR: FA ve MD ölçümlerinde tüm MS hastalarında incelenen korpus kallozum genu, korpus ve splenium, forniks, bilateral forceps major, forceps minor, inferior longitudinal fasikül, prefrontal korteks, talamus alanlarında FA değerleri kontrol grubuna göre düşük saptanır iken MD değerleri aynı alanlarda kontrol grubuna göre yüksek olarak bulunmuştur. Gri ve beyaz cevher volüm değeri açısından hasta grubu kontrol grubundan istatistiksel olarak anlamlı derecede düşük bulunmuştur. Volumetrik analiz ve DTG analizinden FA değerlerinde, MS grubu ile EDSS arasında anlamlı korelasyon izlenmedi. Bilateral forseps majör, prefrontal korteks, globus pallidusta MD değerleri ile EDSS arasında anlamlı bir korelasyon saptandı. TARTIŞMA ve SONUÇ: DTI-traktografi ve volumetrik MRG gibi yeni MRG yöntemleri MS’de aksonal dejenerasyon tutulumunun değerlendirilmesinde önemli katkılar sağlayacaktır.

Relapsing Remitting Multiple Skleroz Hastalarında Difüzyon Tensor Görüntüleme Bulguları: Bir Vaka Kontrol Çalışması

INTRODUCTION: The aim of this study is to determine Diffusion Tensor Imaging (DTI) findings of normal-appearing brain anatomic localizations in Multiple sclerosis (MS) patients. Additionally, volumetric analysis of white and gray matter and correlation with EDDS were performed to interpret structural, functional, and clinical damage in MS patients. METHODS: 32 patients with relapsing remitting MS diagnosis according to McDonald 2010 criteria and 24 healthy volunteers as the control group were included. 3T DTI-tractography and volumetric Magnetic resonance imaging (MRI) were performed in each group and conventional cranial MRI in MS group as well. Mean diffusivity (MD), fractional anisotropy (FA) values of tractography measurements of from various anatomic locations were obtained. EDSS were recorded in MS patients and correlated with DTI parameters and volumetric analysis. RESULTS: FA and MD measurements from corpus callosum genu, body and splenium, fornix, bilateral forceps major, forceps minor, inferior longitudinal fasciculus, prefrontal cortex, thalamus areas revealed that FA values were decreased and MD values were increased in MS patients compared with that of the healthy control group. Grey and white matter volume values were significantly lower in MS patients group. Volumetric analysis and FA values from DTI analysis were not significantly correlated with EDSS in MS group. There was a significant correlation between MD values and EDSS in bilateral forceps major, prefrontal cortex, globus pallidus. DISCUSSION AND CONCLUSION: Advanced MRI techniques such as DTI-tractography and volumetric MRI seem to make remarkable contributions to the evaluation of axonal degeneration in MS.

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Kocaeli Tıp Dergisi-Cover
  • ISSN: 2147-0758
  • Başlangıç: 2012
  • Yayıncı: -