Multimodal Quantitative Mri In Detecting Damage Of Thalamus In Patients With Relapsing Remitting Multiple Sclerosis

Objective:To investigate microstructure,metabolites and volume of thalamus in patients with relapsing remitting multiple sclerosis by DTI,MRS and3D-T1 WI.The correlation between DTI parameters,MRS parameters,volume and clinical neurological dysfunction was also discussed.Methods: According to McDonald2010 diagnostic criteria,we collected 33 cases of relapsing remitting multiple sclerosis(RRMS)patients visiting our hospital during January 2015 to May2016 which make up of the patients group,the control group consists of 33 healthy volunteers whose age and gender are matched with the patient group.RRMS patients were scored the expanded disability status scale(EDSS)by two experienced clinical neurologists before MRI scans were performed.The whole brain DTI data,bilateral thalamic neuronal MRS data,whole brain 3D-T1 WI data were obtained by scanning with the PHILIPS Achieva 3.0T X-Series superconducting magnetic resonance imaging system in the patient group and the control group.Use dcm2 niigui software to convert the original DTI data,the use of PANDA software on the DTI image eddy and head correction and other processing,then the FA,MD,AD and RD values were obtained by the least squares fitting tensor model.FA,MD,AD and RD were extracted from the bilateral thalamus.To analyze the differences of DTI parameters of bilateral thalamus between RRMS patients and control group using independent sample t test.The DTI parameters of the bilateral thalamus and the EDSS score of RRMS patients were analyzed by Person correlation.The levels of NAA,Ins and Glu were analyzed by LC-model software.The values of NAA,Ins and Glu were measured by independent t test.And the differences of NAA,Ins and Glu in the bilateral thalamus of RRMS patients were compared with those of the control group.The data of 3D-T1 WI whole brain structure were pretreated(includingstandardization,segmentation,smoothing,etc).The data of the obtained images were analyzed by statistical software package of SPM,and the thalamus was extracted again by bilateral thalamus template.And the ratio of Vl and Vr of the left and right thalamus volume to the brain parenchymal volume were calculated.The difference of Vl and Vr between the RRMS patients and the control group was analyzed by independent t test.The scores of Vl,Vr and EDSS were analyzed by Person correlation analysis.Results: 1.Compared with the control group,the FA value of bilateral thalamus was significantly lower in RRMS patients(p<0.05),and the levels of MD,AD and RD in bilateral thalamus of RRMS patients were significantly increased(p <0.05);There was no significant correlation between FA,MD,AD,RD and EDSS scores in bilateral thalamus(p> 0.05).2.Compared with the control group,the concentration of NAA in the thalamus of RRMS patients was significantly decreased(p <0.05),the concentration of Ins in the right thalamus of RRMS patients was significantly increased(p<0.05),and the difference of Glu concentrations in the thalamus of RRMS patients was not significant(p>0.05);The NAA concentration of bilateral thalamus in RRMS patients was negatively correlated with EDSS score(Left thalamus r =-0.669,p<0.05;right thalamus r =-708,p <0.05),The Ins concentration of right thalamus in RRMS patients was negatively correlated with EDSS score(r=-0.708,p<0.05),left side of the thalamus Ins,bilateral thalamic Glu concentration in RRMS patients and EDSS score was not related(p > 0.05).3.Compared with the control group,the left thalamic volume of RRMS patients was significantly decreased(p <0.05),the left thalamic volume of RRMS patients did not change(p <0.05);RRMS patients left thalamus and right thalamus volume and EDSS score was not correlated(p> 0.05).Conclusion: 1.There are microstructure changes in the thalamus of RRMS patients.2.The decrease of NAA concentration and the increase of Ins concentration in RRMS patients may be an index to monitor the neurological status of RRMS patients.3.The thalamic volume of RRMS patients can not be used as an indicator of neurological status in RRMS patients.