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目的探讨各向异性分数(fractional anisotropy,FA)值是否可作为肌萎缩侧索硬化症(amyotrophic lateral sclerosis,ALS)病情追踪复查的1个量化指标,分析ALS的FA值与中西医结合治疗后的相关性。方法选取18例ALS患者,采用3.0TPropeller HD MR扫描仪对患者进行前后两次弥散张量成像(diffusion tensor imaging,DTI)检查,选取6个感兴趣区,测量FA值;对11例终点事件进行生存分析。结果 (1)大脑脚、内囊后肢、放射冠3个层面兴趣区(region of interest,ROI)按ALS健康状态量表(health status scale of amyotrophic lateral sclerosis,ALS/HSS)分级,轻度者其FA值最高;(2)18例患者的3个层面大脑脚、内囊后肢、放射冠的初查及复查FA均值比较,差异均有统计学意义(P<0.01);(3)Kaplan-Meier生存曲线提示,随着时间的延长,ALS患者的生存率不断下降。中位生存时间为48.0个月。结论 FA值与ALS病情的分级呈反比,病情越重,FA值越低,FA值是判定ALS患者病情的1个客观指标。ALS目前尚为不治之症,中西医结合治疗或许可能是ALS患者治疗的一个方向。
Objective To investigate whether the fractional anisotropy (FA) value can be used as a quantitative indicator of the follow-up of amyotrophic lateral sclerosis (ALS). The FA value of ALS was analyzed after treatment with traditional Chinese and western medicine Correlation. Methods Eighteen patients with ALS were selected and examined by diffusion tensor imaging (DTI) before and after treatment with 3.0 TPropeller HD MR scanner. Six regions of interest were selected and FA values were measured. Eleven end-point events were performed subsistence analysis. Results (1) The region of interest (ROI) was classified according to the health status scale of amyotrophic lateral sclerosis (ALS / HSS) in brain feet, internal capsule and hind limbs, (2) There were significant differences in the initial examinations and retrospective FA between the cerebral peduncle, the inner hindlimbs and the radicles of the three layers in 18 patients (P <0.01); (3) The Kaplan-Meier Survival curves suggest that the survival rate of patients with ALS declines with time. The median survival time was 48.0 months. Conclusions The FA value is inversely proportional to the grading of ALS. The more serious the disease, the lower the FA value. The FA value is an objective index to judge the severity of ALS. ALS is currently an incurable disease, Integrative Medicine may be possible treatment of ALS in one direction.