Multiple sclerosis lesions and atrophy in the spinal cord: Distribution across vertebral levels and correlation with disability.
Multiple sclerosis lesions and atrophy in the spinal cord: Distribution across vertebral levels and correlation with disability.
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DOI：
10.1016/j.nicl.2022.103006
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发表时间：
2022
影响因子：
4.2
通讯作者：
Muhlau, Mark
中科院分区：
文献类型：
--
作者：
Bussas, Matthias;El Husseini, Malek;Harabacz, Laura;Pineker, Viktor;Grahl, Sophia;Pongratz, Viola;Berthele, Achim;Riederer, Isabelle;Zimmer, Claus;Hemmer, Bernhard;Kirschke, Jan S.;Muhlau, Mark
在多发性硬化症中，在大型患者队列和健康对照受试者中，脊髓病变和萎缩可通过具有轴向和矢状面覆盖的全脊髓MRI测量。脊髓损伤和萎缩在颈椎增大时加重。它们已经在RRMS阶段发展，并在以后的阶段以具有临床意义的方式继续发展。但它们在很大程度上仍然是独立的。绝大多数关于多发性硬化（MS）的磁共振成像（MRI）研究覆盖了脊髓（SC），如果有的话，也是不完全的。评估MS中SC受累（通过全SC MRI可检测）在椎体水平上的分布以及与临床表型和残疾的关系。我们研究了矢状面和轴向覆盖的SC MRI。分析了17名健康对照（HC）和370名临床孤立综合征（CIS，27）、复发缓解型MS（RRMS，303）或进展型MS（PMS，40）患者的脑部和SC MRI扫描。在椎体水平，横截面积半自动分割，病变手动划定。SC病变的频率在C3-4节段最高。从CIS到RRMS，从RRMS到PMS，SC病变体积增加，而SC节段的病变分布没有差异。在RRMS中证实了SC萎缩，在PMS中的程度更高;除了C3-4节段加重外，SC萎缩均匀分布在SC节段上。SC病变和萎缩体积彼此不相关，与残疾独立相关。在整个SC中，在RRMS阶段已经存在SC病变和萎缩，在宫颈增大中加重;在PMS阶段，SC病变和萎缩更明显。两者都有助于临床表现，但在很大程度上是独立的。
In multiple sclerosis, spinal cord lesions and atrophy are measurable by whole spinal cord MRI with axial and sagittal coverage in a large patient cohort and in healthy control subjects. Spinal cord lesions and atrophy are accentuated in the cervical enlargement. They have already developed at the stage of RRMS and continue developing in a clinically meaningful way at later stages. Yet they remain largely independent. The vast majority of magnetic resonance imaging (MRI) studies on multiple sclerosis (MS) covered the spinal cord (SC), if at all, incompletely. To assess SC involvement in MS, as detectable by whole SC MRI, with regard to distribution across vertebral levels and relation to clinical phenotypes and disability. We investigated SC MRI with sagittal and axial coverage. Analyzed were brain and SC MRI scans of 17 healthy controls (HC) and of 370 patients with either clinically isolated syndrome (CIS, 27), relapsing remitting MS (RRMS, 303) or progressive MS (PMS, 40). Across vertebral levels, cross-sectional areas were semiautomatically segmented, and lesions manually delineated. The frequency of SC lesions was highest at the level C3-4. The volume of SC lesions increased from CIS to RRMS, and from RRMS to PMS whereas lesion distribution across SC levels did not differ. SC atrophy was demonstrated in RRMS and, to a higher degree, in PMS; apart from an accentuation at the level C3-4, it was evenly distributed across SC levels. SC lesions and atrophy volume were not correlated with each other and were independently associated with disability. SC lesions and atrophy already exist at the stage of RRMS in the whole SC with an accentuation in the cervical enlargement; SC lesions and atrophy are more pronounced in the stage of PMS. Both contribute to the clinical picture but are largely independent.
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