本文選題：頸髓　切入點(diǎn)：磁共振彌散張量成像　出處：《吉林大學(xué)》2014年碩士論文

【摘要】：目的： 利用3.0T磁共振DTI技術(shù)對MS、NMO及ATM三種疾病在頸髓的病變特點(diǎn)進(jìn)行定量研究，以此對這三種神經(jīng)內(nèi)科的脊髓常見疾病有更進(jìn)一步的認(rèn)識(shí)，為疾病的鑒別診斷及治療、預(yù)后提供一定程度上的幫助。 資料與方法： 自2013年1月至2014年1月期間于吉林大學(xué)白求恩第一醫(yī)院神經(jīng)內(nèi)科住院病人中依據(jù)McDonald診斷標(biāo)準(zhǔn)收集急性期MS患者4例；依據(jù)Wingerchuk診斷標(biāo)準(zhǔn)收集NMO患者3例；依據(jù)急性脊髓炎診斷標(biāo)準(zhǔn)收集了急性脊髓炎患者2例；招募健康志愿者9例。就所收集的相關(guān)數(shù)據(jù)，本研究展開了以下幾組分析比較： 1、急性期的腦型MS患者頸髓與正常對照組之間頸髓DTI的比較； 2、急性期腦脊髓型MS、靜止期腦脊髓型MS患者分別與正常對照組頸髓之間DTI的比較； 3、急性期NMO患者頸髓T2異常區(qū)、T2正常區(qū)及正常對照組之間的比較； 4、急性脊髓炎患者頸髓T2異常區(qū)與正常對照組之間的比較； 5、急性期MS患者頸髓T2異常區(qū)、NMO患者T2異常區(qū)及正常對照組之間的比較； 6、對實(shí)驗(yàn)組頸髓T2異常區(qū)內(nèi)左右兩側(cè)、頸髓無T2異常區(qū)患者的頸髓全節(jié)段的左右兩側(cè)進(jìn)行比較； 7、對實(shí)驗(yàn)組中頸髓存在T2異常的患者的病灶中心區(qū)的左右兩側(cè)進(jìn)行比較。 掃描設(shè)備采用的是由德國Siemens公司生產(chǎn)的超導(dǎo)型Trio Tim3.0T MR成像儀。統(tǒng)計(jì)學(xué)數(shù)據(jù)處理采用的是SPSS17.0windows軟件處理數(shù)據(jù)，結(jié)果均以均數(shù)±標(biāo)準(zhǔn)差表示，以P㩳0.5為有統(tǒng)計(jì)學(xué)意義。 結(jié)果： 1、急性期的腦型MS的頸髓FA值均值較正常對照組明顯降低（P＜0.05）；急性期及靜止期的腦脊髓型MS頸髓病灶內(nèi)FA值均值均較正常對照組有明顯下降（P＜0.05），且前者較后者下降程度更顯著（P＜0.05）；MS病灶處FA圖、DEC圖的顏色信號明顯減低，所顯示的病灶面積未發(fā)現(xiàn)明顯大于常規(guī)序列T1、T2上所顯示的病灶面積；在DTT上可以看到MS病灶處纖維束較正常對照相對稀疏，，未看見明顯的纖維束中斷現(xiàn)象。 2、急性期的NMO患者頸髓T2異常處、T2正常處與正常對照組比較FA值均值均有明顯下降（P＜0.05）。 3、急性脊髓炎患者頸髓病灶處與正常對照組比較FA均值有明顯下降（P＜0.05）。 4、急性期的NMO患者頸髓病灶中心區(qū)較急性期的MS患者頸髓病灶中心區(qū)的FA值下降明顯（P＜0.05）；NMO病灶處FA圖、DEC圖的顏色信號明顯減低，在DTT上可以看到NMO病灶處纖維束較正常對照相對稀疏。 5、腦型MS、急性期腦脊髓型MS、靜止期腦脊髓型MS、急性期NMO及急性脊髓炎的頸髓左右兩側(cè)FA值均值比較未見明顯差異性（P＞0.05）；發(fā)現(xiàn)一例MS、一例NMO患者頸髓病灶中心區(qū)內(nèi)左右兩側(cè)FA值均值比較有明顯差異（P＜0.05）,神經(jīng)功能缺損嚴(yán)重側(cè)FA均值下降更明顯。 結(jié)論： 1、腦型MS患者的頸髓亦存在隱匿性損傷； 2、 NMO患者看似正常的脊髓(NASC, normal-appearing spinal cord)區(qū)內(nèi)存在隱匿性損傷，NMO頸髓病損程度較MS較嚴(yán)重； 3、DTI在一定程度上可對MS、NMO及急性脊髓炎的病情進(jìn)行量化的評判，進(jìn)而對患者的預(yù)后判斷有一定的幫助。
[Abstract]:Objective:
Using 3.0T magnetic resonance DTI technology, we quantitatively studied the characteristics of the three diseases of MS, NMO and ATM in the cervical spinal cord, so as to further understand the three common diseases of the spinal cord, and provide some help for the differential diagnosis, treatment and prognosis of the disease.
Information and methods:
From January 2013 to January 2014 in the first hospital of Jilin University, Bethune Department of neurology patients according to the diagnostic criteria for McDonald were collected in 4 cases of acute MS patients; according to the diagnostic criteria for Wingerchuk 3 patients with NMO; according to the standard in diagnosis of acute spinal cord were collected in patients with acute myelitis in 2 cases; 9 cases of healthy volunteers were recruited. The relevant data collected in this study, the following group analysis:
1, the comparison of cervical spinal cord DTI between the cervical spinal cord and the normal control group in the acute cerebral MS patients.
2, the acute phase of cerebral spinal cord MS, the rest of the brain and spinal cord MS patients were compared with the normal control group of the cervical spinal cord of DTI.
3, in the acute phase of NMO, the abnormal T2 area of the cervical spinal cord, the normal T2 area and the normal control group were compared.
4, the comparison between the abnormal T2 area of the cervical spinal cord and the normal control group in the patients with acute myelitis.
5, the abnormal T2 area of the cervical spinal cord in the acute MS patients, the comparison of the abnormal T2 area of the NMO patients and the normal control group.
6, the left and right sides of the cervical spinal cord in the cervical spinal cord T2 abnormal area in the experimental group and the cervical spinal cord with no T2 abnormal area were compared.
7, the left and right sides of the center of the lesion were compared in the patients with T2 abnormalities in the cervical spinal cord in the experimental group.
The scanning device is a superconducting Trio Tim3.0T MR imager produced by Siemens company. The data are processed by SPSS17.0windows software, and the results are all expressed by mean + standard deviation. P 0.5 has statistical significance.
Result錛

本文編號：1676955