Longitudinally extensive optic neuritis as an MRI biomarker distinguishes neuromyelitis optica from multiple sclerosis.
Longitudinally extensive optic neuritis as an MRI biomarker distinguishes neuromyelitis optica from multiple sclerosis.
复制标题
DOI：
10.1016/j.jns.2015.05.013
复制
发表时间：
2015-08-15
影响因子：
4.4
通讯作者：
Levy, Michael
中科院分区：
文献类型：
--
作者：
Mealy, Maureen A.;Whetstone, Anna;Orman, Gunes;Izbudak, Izlem;Calabresi, Peter A.;Levy, Michael
关键词：
目的探讨视神经炎合并视神经脊髓炎(NMO)和复发性缓解性多发性硬化症(RRMS)的MRI表现。视神经炎是视神经脊髓炎和多发性硬化症的共同表现。区分NMO和RRMS对指导治疗很重要，但NMO和MS的生物标志物可能在疾病过程的早期就缺失了。我们寻找与NMO和MS相关的视神经炎的MRI特征的差异，为诊断工作提供早期线索。我们对在约翰霍普金斯医院就诊的26例NMO和26例RRMS患者进行了回顾性分析，这些患者的MRI证实为急性视神经炎。评估磁共振成像以确定每个对比度增强病变的位置和纵向范围。在本研究中，视神经被分为眶内、小管、视交叉前、视交叉和视束。NMO相关性视神经炎和RRMS相关性视神经炎的MRI表现有明显差异。大多数NMO病变是纵向扩展的，长度至少为17.6毫米，至少累及三个视神经节段。当病变长度为17.6 mm时，NMO的特异度为76.9%，敏感度为80.8%，阳性似然比为3.50。相反，MS病变更常见于位于视神经前部的一个节段。与RRMS相比，NMO的视神经炎在MRI上有不同的模式，有助于区分这两种神经炎性疾病。
To differentiate MRI characteristics of optic neuritis associated with neuromyelitis optica (NMO) and relapsing remitting multiple sclerosis (RRMS). Optic neuritis is a common presenting feature of both neuromyelitis optica and multiple sclerosis. Distinguishing between NMO and RRMS is important in guiding treatment, but biomarkers of NMO and MS can be absent early in the disease process. We looked for differences in MRI characteristics of optic neuritis associated with NMO and MS that provide an early clue in the diagnostic workup. We conducted a retrospective analysis of 26 NMO and 26 RRMS patients presenting to the Johns Hopkins Hospital with MRI-confirmed acute optic neuritis. MRIs were assessed to identify the location and longitudinal extent of each contrast enhancing lesion. For the purposes of this study, the optic nerve was divided into intraorbital, canalicular, pre-chiasmal, chiasmal, and optic tract. There are distinct differences in MRI characteristics between NMO- and RRMS-associated optic neuritis. The majority of NMO lesions were longitudinally extensive measuring at least 17.6 mm in length and involving at least three optic nerve segments. At a cutoff of 17.6 mm lesion length, the specificity for NMO is 76.9% with a sensitivity of 80.8% and positive likelihood ratio of 3.50. Conversely, MS lesions were more commonly focal in one optic nerve segment localized anteriorly. Optic neuritis in NMO has a distinct pattern on MRI as compared with RRMS and can help differentiate these two neuroinflammatory diseases at presentation.
登录
查看更多内容
影响因子：
5.8
作者：
Min, Ju-Hong;Kim, Byoung Joon;Lee, Kwang Ho
通讯作者：
Lee, Kwang Ho
影响因子：
1.9
作者：
Graves, Jennifer;Kraus, Verena;Waubant, Emmanuelle
通讯作者：
Waubant, Emmanuelle
影响因子：
5.8
作者：
Kim, Su-Hyun;Kim, Woojun;Kim, Ho Jin
通讯作者：
Kim, Ho Jin
影响因子：
11
作者：
Green, A. J.;Cree, B. A. C.
通讯作者：
Cree, B. A. C.
影响因子：
14.5
作者：
Gelfand, Jeffrey M.;Nolan, Rachel;Green, Ari J.
通讯作者：
Green, Ari J.