Magnetization transfer ratio evolution with demyelination and remyelination in multiple sclerosis lesions
Magnetization transfer ratio evolution with demyelination and remyelination in multiple sclerosis lesions
复制标题
DOI：
10.1002/ana.21302
复制
发表时间：
2008-02-01
影响因子：
11.2
通讯作者：
Arnold, Douglas L.
中科院分区：
文献类型：
--
作者：
Chen, Jacqueline T.;Collins, D. Louis;Arnold, Douglas L.
目的：评估多发性硬化（MS）急性钆（Gd）增强病变的脱髓鞘和髓鞘再生。方法：我们测量了与单个病变体素的脱髓鞘和髓鞘再生一致的磁化传递率（MTR）的显着变化，以及对比增强期间和之后所有病变体素的平均标准化MTR，在MS患者参加了3年的加拿大试验评估免疫消融和自体干细胞移植治疗MS。结果：平均平均归一化病变MTR在所有病变表现出部分恢复超过2至4个月后Gd增强。基于体素的分析表明，在39个月的评价中，约70%的初始增强病变体积（GdLV）保持稳定的低MTR。经历MTR显著增加的GdLV百分比与髓鞘再生一致，在增强后增加约7个月，然后稳定在21%GdLV。增强后约33个月，MTR显著降低（与脱髓鞘一致），稳定在9%GdLV。这些测量的估计误差，扫描/再扫描分析的基础上，是小于0.4%GdLV.Interpretation：我们发现显着的变化MTR符合脱髓鞘和髓鞘再生，遵循不同的时间演变，并在不同的病变区域进行至少3年后病变形成。
Objective: To assess demyelination and remyelination in vivo in acute gadolinium (Gd)-enhancing lesions of multiple sclerosis (MS).Methods: We measured significant changes in magnetization transfer ratio (MTR) consistent with demyelination and remyelination of individual lesion voxels, as well as the mean normalized MTR over all lesion voxels during and after contrast enhancement, in MS patients participating in a 3-year Canadian trial assessing immunoablation and autologous stem cell transplantation for treatment of MS.Results: The average mean normalized lesion MTR over all lesions exhibited partial recovery over 2 to 4 months after Gd enhancement. Voxel-based analysis demonstrated that approximately 70% of the initially enhancing lesion volume (GdLV) was left with stably low MTR over 39 months of evaluation. The percentage of the GdLV undergoing significant increases in MTR consistent with remyelination increased for approximately 7 months after enhancement and then stabilized at 21 %GdLV. Significant decreases in MTR consistent with demyelination were ongoing for approximately 33 months after enhancement, stabilizing at 9 %GdLV. The estimated error of these measurements, based on scan/rescan analysis, was less than 0.4 %GdLV.Interpretation: We found significant changes in MTR consistent with demyelination and remyelination that followed different temporal evolutions and were ongoing in different lesion regions for at least 3 years after lesion formation.