摘要目的：利用磁敏感加权成像（SWI）研究多发性硬化(MS)患者脑深部静脉血氧含量，探讨其反映临床病情的能力。方法前瞻性收集经临床确诊（McDonald标准，2005年修订版）的MS患者44例（MS组）及年龄、性别相匹配的健康志愿者65名（对照组），所有患者均行常规MRI以及SWI检查；其中12例间隔12～16个月后行MRI复查。MS组扩展残疾状况评分（EDSS）分值为0.5~6.5分。采用SWI神经系统处理软件（SPIN）测量脑深部小静脉血管与周围组织的相位值差（Δφ）来反映其血氧含量，分别选取双侧基底静脉（BV）、大脑中浅静脉（SMCV）、大脑内静脉（ICV）、丘纹上静脉（STV）以及额叶髓静脉（FMV)、顶叶髓静脉（PMV)和枕叶髓静脉（OMV)。MS组和对照组之间各静脉血Δφ的差异采用独立样本t检验进行对照分析；MS组2个时间点的静脉血Δφ变化采用配对t检验；MS组静脉Δφ与EDSS相关性分析采用Spearman相关分析。结果 MS患者BV、SMCV、ICV、STV的Δφ值分别为856.6±246.4、600.6±155.2、965.9±205.4、844.2±149.7，对照组分别为767.6±145.1、536.2±123.5、892.8±156.3、783.1±148.5，MS组均高于对照组，差异有统计学意义（t值分别为2.157、2.303、2.005、2.103，P值均<0.05）。12例MS患者首次检查时BV、ICV、STV的Δφ值分别为729.4±275.1、906.1±219.2、737.2±159.1，复查时分别为923.2±211.6、1017.3±211.1、919.3±165.9，均较首次检查时增大，差异有统计学意义（t值分别为－3.092、－6.420、－3.972，P值均<0.05）；MS患者PMV、OMV的Δφ值与EDSS呈正相关（r值分别为0.638、0.642，P值均<0.01）。结论 MS患者的脑组织处于缺氧状态；随患病时间延长缺氧加剧,缺氧程度可反映MS患者的残疾状态。

abstractsObjective To evaluate the deep brain venous blood oxygen content changes in patients with multiple sclerosis(MS) using susceptibility weighted imaging (SWI), and to explore the ability of SWI in reflecting the clinical condition. Methods Forty-four MS patients were prospectively enrolled in the study. All the clinical-proved patients meeting the McDonald standards (2005 revised) underwent conventional MRI, SWI, and 12 cases of them underwent MRI review from 12 to 16 months interval. all the patients' clinical condition were quantified according to the expanded disability status scale(EDSS). The score was 0.5—6.5. Sixty-five age- and gender- matched healthy volunteers underwent conventional MRI and SWI. The blood oxygen content of the deep brain venous were estimated by the veins phase value, and differential phase values of blood vessels and surrounding tissues (Δφ) were processed with SPIN software. The blood vessels consist of bilateral BV, SMCV, ICV, STV and FMV, PMV, OMV. The difference of Δφvalue in different veins between MS patients and the controls was compared using independent sample t-test, and the Δφ value comparison of MS patients in different time were performed by using paired t test; The&nbsp;correlation ofΔφvalue between MS and EDSS was analyzed using Spearman correlation. Results TheΔφvalue of BV, SMCV, ICV, STV were 856.6 ± 246.4, 600.6 ± 155.2, 965.9 ± 205.4, 844.2 ± 149.7 in MS, and 767.6±145.1, 536.2±123.5, 892.8±156.3, 783.1±148.5 in controls, respectively. TheΔφvalue was higher in MS patients than the controls (t=2.157, 2.303, 2.005, 2.103,P<0.05). The twelve patients'Δφvalues of BV, ICV,STV were 729.4±275.1, 906.1±219.2, 737.2±159.1 in the first time, and 923.2±211.6, 1017.3±211.1, 919.3 ± 165.9 in the second time, and all the values increased in the review of the interval of 12 to 16 months (t=-3.092,-6.420,-3.972,P<0.05). The phase value of PMV and OMV had significant positive correlation with EDSS scores(r=0.638, 0.642,P<0.01). Conclusions The state of hypoxia of the brain parenchyma appears in MS patients, and hypoxia may become worse with the extension of course. The extent of hypoxia can reflect the disability of the patients.