Meningeal contrast enhancement in multiple sclerosis: assessment of field strength, acquisition delay, and clinical relevance.
Meningeal contrast enhancement in multiple sclerosis: assessment of field strength, acquisition delay, and clinical relevance.
复制标题
多发性硬化症的脑膜对比增强：场强、采集延迟和临床相关性的评估。
DOI：
10.1101/2024.03.04.24303491
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发表时间：
2024
期刊：
影响因子：
--
通讯作者：
Hua,Jun
中科院分区：
文献类型：
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作者：
Harrison,DanielM;Allette,YohanceM;Zeng,Yuxin;Cohen,Amanda;Dahal,Shishir;Choi,Seongjin;Zhuo,Jiachen;Hua,Jun
背景/目的增强后FLAIR的脑膜强化(LME)被认为是多发性硬化(MS)脑膜炎症的潜在生物标志物。在这里，我们报告了MRI磁场强度和采集时机对脑膜对比增强(MCE)的影响的评估。方法这是一项横断面观察性研究，对象为95名MS患者和17名健康对照(HC)受试者。每个参与者都接受了7特斯拉(7T)和3特斯拉(3T)核磁共振扫描仪的大脑核磁共振检查。7T方案包括在Gd之前、之后不久(Gd+早期7T FLAIR)和Gd后23分钟(Gd+延迟7T FLAIR)进行FLAIR成像。结果Gd+延迟3T FLAIR组、Gd+早期7T FLAIR组和Gd+延迟7T FLAIR组LME发生率分别为23.3%、47.4%和57.9%(P分别为0.001和0.008)。Gd+延迟7T FLAIR的LME、软脑膜和血管旁强化(LMPE)、血管旁和硬膜强化(PDE)的数目和体积最高，Gd+延迟3T FLAIR最低。与HCS相比，MS中的LME和PDE的比例、数量和数量都有所增加，这一趋势并不显著。Gd+延迟7T FLAIR的LMPE发生率MS组为98.9%，HCS组为82.4%，P=0.003。接受Gd+延迟7T FLAIR检查的MS患者年龄(47.610.6岁)明显高于未接受7TFLAIR检查的患者(42.09.7岁，p=0.008)。然而，LME在不同组间的差异及其与年龄的关联，令人质疑其作为MS脑膜炎症生物标志物的相关性。
Background/PurposeLeptomeningeal enhancement (LME) on post-contrast FLAIR is described as a potential biomarker of meningeal inflammation in multiple sclerosis (MS). Here we report an assessment of the impact of MRI field strength and acquisition timing on meningeal contrast enhancement (MCE).MethodsThis was a cross-sectional, observational study of 95 participants with MS and 17 healthy controls (HC) subjects. Each participant underwent an MRI of the brain on both a 7 Tesla (7T) and 3 Tesla (3T) MRI scanner. 7T protocols included a FLAIR image before, soon after (Gd+ Early 7T FLAIR), and 23 minutes after gadolinium (Gd+ Delayed 7T FLAIR). 3T protocol included FLAIR before and 21 minutes after gadolinium (Gd+ Delayed 3T FLAIR).ResultsLME was seen in 23.3% of participants with MS on Gd+ Delayed 3T FLAIR, 47.4% on Gd+ Early 7T FLAIR (p = 0.002) and 57.9% on Gd+ Delayed 7T FLAIR (p < 0.001 and p = 0.008, respectively). The count and volume of LME, leptomeningeal and paravascular enhancement (LMPE), and paravascular and dural enhancement (PDE) were all highest for Gd+ Delayed 7T FLAIR and lowest for Gd+ Delayed 3T FLAIR. Non-significant trends were seen for higher proportion, counts, and volumes for LME and PDE in MS compared to HCs. The rate of LMPE was different between MS and HCs on Gd+ Delayed 7T FLAIR (98.9% vs 82.4%, p = 0.003). MS participants with LME on Gd+ Delayed 7T FLAIR were older (47.6 (10.6) years) than those without (42.0 (9.7), p = 0.008).Conclusion7T MRI and a delay after contrast injection increased sensitivity for all forms of MCE. However, the lack of difference between groups for LME and its association with age calls into question its relevance as a biomarker of meningeal inflammation in MS.