Multipl Sklerozlu Hastalarda Perfüzyon Ağırlıklı Manyetik Rezonans Görüntüleme Bulguları ve Klinik Testler ile İlişkisi
Öz
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
Anahtar Kelimeler
Multipl skleroz perfüzyon ağırlıklı manyetik rezonans görüntüleme nörolojik defisit
Kaynakça
- Varga AW, Johnson G, Babb JS, ve ark. White matter he- modynamic abnormalities precede sub-cortical gray matter changes in multiple sclerosis. J Neurol Sci 2009; 282: 28-33.
- Wuerfel J, Bellmann-Strobl J, Brunecker P, et al. Changes in cerebral perfusion precede plaque formation in multiple sclerosisA: a longitudinal perfusion MRI study. Brain 2004; 127:111-9.
- Hauser SL, Multiple sclerosis and other demyelinating dise- ases. Harrison’s Principles of Internal Medicine, ed. K.J.W.J. Isselbacher, Martin, J.B., Fauci, A.S., Kasper, D.L. McG- raw-Hill, New York, 1994; pp. 2287–95.
- Steinman L, Martin R, Bernard C, Conlon P Oksenberg JR. Multiple sclerosis: deeper understanding of its pathogenesis reveals new targets for therapy. Annu Rev Neurosci 2002; 25:491-505.
- Mesaros S, Rocca MA, Kacar K, et al. Diffusion tensor MRI tractography and cognitive impairment in multiple sclero- sis. Neurology 2012; 78: 969-75.
- Chen Y, Wolk DA, Reddin JS, et al. Voxel-level comparison of arterial spinlabeled perfusion MRI and FDG-PET in Al- zheimer disease. Neurology 2011;77: 1977-85.
- Latchaw RE. Cerebral perfusion imaging in acute stroke. J Vasc Interv Radiol 2004; 15: 29-46.
- Roberts GW, Larson KB,Spaeth EE. The interpretation of mean transit time measurements for multiphase tissue sys- tems. J Theor Biol 1973; 39: 447-75.
- Rosen BR, Belliveau JW, Vevea JM,Brady TJ. Perfusion ima- ging with NMR contrast agents. Magn Reson Med 1990;14: 249-65.
- Harris JO, Frank JA, Patronas N, McFarlin DE, McFarland HF. Serial gadolinium-enhanced magnetic resonance ima- ging scans in patients with early, relapsing-remitting mul- tiple sclerosis: implications for clinical trials and natural history. Ann Neurol 1991; 29: 548-55.
- McFarland HF, Frank JA, Albert PS, et al. Using Gadolini- um-Enhanced Magnetic-Resonance-Imaging Lesions To Monitor Disease-Activity In Multiple-Sclerosis. Annals of Neurology 1992; 32: 758-66.
- Adams CWM, Poston RN, Buk SJ. Pathology, Histoche- mistry And Immunocytochemistry Of Lesions In Acute Multiple-Sclerosis. J Neurological Sciences 1989; 92: 291- 306.
- Kurtzke JF. Rating Neurologic Impairment In Multip- le-Sclerosis - An Expanded Disability Status Scale (EDSS). Neurology 1983: 33; 1444-52.
- Goodkin DE, Cookfair D, Wende K, et al. Interrater And Intrarater Scoring Agreement Using Grades 1.0 To 3.5 Of The Kurtzke Expanded Disability Status Scale (EDSS). Neurology 1992: 42; 859-63.
- Cutter GR, Baier ML, Rudick RA, et al. Development of a multiple sclerosis functional composite as a clinical trial outcome measure. Brain 1999: 122; 871-82.
- Adhya S, Johnson G, Herbert J, et al. Pattern of hemodyna- mic impairment in multiple sclerosis: dynamic susceptibi- lity contrast perfusion MR imaging at 3.0 T. Neuroimage 2006; 33: 1029-35.
Öz
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
Anahtar Kelimeler
Multiple sclerosis perfusion weighted magnetic resonance imaging neurologic deficit
Kaynakça
- Varga AW, Johnson G, Babb JS, ve ark. White matter he- modynamic abnormalities precede sub-cortical gray matter changes in multiple sclerosis. J Neurol Sci 2009; 282: 28-33.
- Wuerfel J, Bellmann-Strobl J, Brunecker P, et al. Changes in cerebral perfusion precede plaque formation in multiple sclerosisA: a longitudinal perfusion MRI study. Brain 2004; 127:111-9.
- Hauser SL, Multiple sclerosis and other demyelinating dise- ases. Harrison’s Principles of Internal Medicine, ed. K.J.W.J. Isselbacher, Martin, J.B., Fauci, A.S., Kasper, D.L. McG- raw-Hill, New York, 1994; pp. 2287–95.
- Steinman L, Martin R, Bernard C, Conlon P Oksenberg JR. Multiple sclerosis: deeper understanding of its pathogenesis reveals new targets for therapy. Annu Rev Neurosci 2002; 25:491-505.
- Mesaros S, Rocca MA, Kacar K, et al. Diffusion tensor MRI tractography and cognitive impairment in multiple sclero- sis. Neurology 2012; 78: 969-75.
- Chen Y, Wolk DA, Reddin JS, et al. Voxel-level comparison of arterial spinlabeled perfusion MRI and FDG-PET in Al- zheimer disease. Neurology 2011;77: 1977-85.
- Latchaw RE. Cerebral perfusion imaging in acute stroke. J Vasc Interv Radiol 2004; 15: 29-46.
- Roberts GW, Larson KB,Spaeth EE. The interpretation of mean transit time measurements for multiphase tissue sys- tems. J Theor Biol 1973; 39: 447-75.
- Rosen BR, Belliveau JW, Vevea JM,Brady TJ. Perfusion ima- ging with NMR contrast agents. Magn Reson Med 1990;14: 249-65.
- Harris JO, Frank JA, Patronas N, McFarlin DE, McFarland HF. Serial gadolinium-enhanced magnetic resonance ima- ging scans in patients with early, relapsing-remitting mul- tiple sclerosis: implications for clinical trials and natural history. Ann Neurol 1991; 29: 548-55.
- McFarland HF, Frank JA, Albert PS, et al. Using Gadolini- um-Enhanced Magnetic-Resonance-Imaging Lesions To Monitor Disease-Activity In Multiple-Sclerosis. Annals of Neurology 1992; 32: 758-66.
- Adams CWM, Poston RN, Buk SJ. Pathology, Histoche- mistry And Immunocytochemistry Of Lesions In Acute Multiple-Sclerosis. J Neurological Sciences 1989; 92: 291- 306.
- Kurtzke JF. Rating Neurologic Impairment In Multip- le-Sclerosis - An Expanded Disability Status Scale (EDSS). Neurology 1983: 33; 1444-52.
- Goodkin DE, Cookfair D, Wende K, et al. Interrater And Intrarater Scoring Agreement Using Grades 1.0 To 3.5 Of The Kurtzke Expanded Disability Status Scale (EDSS). Neurology 1992: 42; 859-63.
- Cutter GR, Baier ML, Rudick RA, et al. Development of a multiple sclerosis functional composite as a clinical trial outcome measure. Brain 1999: 122; 871-82.
- Adhya S, Johnson G, Herbert J, et al. Pattern of hemodyna- mic impairment in multiple sclerosis: dynamic susceptibi- lity contrast perfusion MR imaging at 3.0 T. Neuroimage 2006; 33: 1029-35.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Original Article |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Aralık 2018 |
| Yayımlandığı Sayı | Yıl 2018 Cilt: 28 Sayı: 4 |
Genel Tıp Dergisi Creative Commons Atıf-GayriTicari 4.0 Uluslararası Lisansı (CC BY NC) ile lisanslanmıştır.