Clinical trials and clinical practice in multiple sclerosis: conventional and emerging magnetic resonance imaging technologies.
Clinical trials and clinical practice in multiple sclerosis: conventional and emerging magnetic resonance imaging technologies.
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DOI：
10.1007/s11910-002-0086-2
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发表时间：
2002-05-01
影响因子：
5.6
通讯作者：
Rovaris, Marco
中科院分区：
文献类型：
--
作者：
Filippi, Massimo;Rocca, Maria A;Rovaris, Marco
常规磁共振成像（cMRI）被广泛用于诊断多发性硬化症（MS），并作为一种临床旁工具，以监测疾病的活动和演变的自然史研究和临床试验。然而，cMRI与临床结果之间的相关性远非严格，当从大规模研究的背景转移到个体患者的管理时，这种差异更加明显。这种“临床MRI悖论”的原因之一是cMRI对MS异质性病理基质的特异性有限，并且无法量化正常组织中的损伤程度。现代定量MR技术有可能克服cMRI的一些局限性。虽然现代MR技术的应用正在极大地改变我们对MS如何导致不可逆残疾的理解，但其用于临床试验监测和临床实践仍然非常有限。尽管越来越多的人认为现代定量MR技术应更广泛地应用于临床试验，以促进对MS的理解并获得创新信息，但其在临床实践中的应用仍应被视为过早。
Conventional magnetic resonance imaging (cMRI) is widely used for diagnosing multiple sclerosis (MS) and as a paraclinical tool to monitor disease activity and evolution in natural history studies and clinical trials. However, the correlation between cMRI and clinical findings is far from strict, and such a discrepancy is even more evident when moving from the setting of large-scale studies to the management of individual patients. Among the reasons for this "clinical-MRI paradox" is the limited specificity of cMRI to the heterogeneous pathologic substrates of MS and its inability to quantify the extent of damage in the normal-appearing tissues. Modern quantitative MR techniques have the potential to overcome some of the limitations of cMRI. Although the application of modern MR techniques is changing dramatically our understanding of how MS causes irreversible disability, their use for clinical trial monitoring and clinical practice is still very limited. Whereas there is increasing perception that modern quantitative MR techniques should be more extensively employed in clinical trials to advance the understanding of MS and derive innovative information, their use in clinical practice should still be regarded as premature.