Tissue damage within normal appearing white matter in early multiple sclerosis: assessment by the ratio of T1-and T2-weighted MR image intensity
Tissue damage within normal appearing white matter in early multiple sclerosis: assessment by the ratio of T1-and T2-weighted MR image intensity
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DOI：
10.1007/s00415-016-8156-6
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发表时间：
2016-08-01
影响因子：
6
通讯作者：
Muehlau, M.
中科院分区：
文献类型：
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作者：
Beer, A.;Biberacher, V.;Muehlau, M.
组织学和磁共振成像（MRI）研究表明，多发性硬化（MS）早期的白色物质（WM）损害超出了明显的T2高信号病变。这些正常表现的WM（NAWM）的变化对于临床表现和预后是重要的。然而，NAWM内的变化检测到目前为止，需要特殊的成像技术，通常无法在临床常规，因此，在大规模。本研究的目的是通过常规MRI检测MS相关的NAWM损害。由于在NAWM内，髓鞘含量主要驱动T1加权（T1 w）信号，因此我们通过T2 w信号对其进行缩放。我们测试了这样的假设：与健康对照（HC）相比，MS中NAWM的平均T1 w/T2 w比率降低，并且它与临床测量相关。我们开发了一个管道来确定NAWM中该比率的单个平均值。我们研究了244例处于MS早期疾病阶段的患者（平均年龄37 +/-A10岁，平均病程3.1 +/-A2.3，扩展残疾状态量表1.3 +/-A1）和78例HC（平均年龄31 +/-A8岁）。与HC相比，患者组的平均T1 w/T2 w比值降低（P < 0.001）。在将分析限制在疾病持续时间为5年或更短且未使用疾病改善药物的患者后，差异仍然显著。我们的测量也与临床评分相关。我们认为，平均T1 w/T2 w比值是一个有前途的候选人，以评估MS相关的组织损伤在NAWM在大规模。
Histopathological and magnetic resonance imaging (MRI) studies have shown white matter (WM) damage in early stages of multiple sclerosis (MS) beyond the apparent T2-hyperintense lesions. These changes in normal appearing WM (NAWM) are important with regard to the clinical picture and prognosis. However, the detection of changes within NAWM has so far required special imaging techniques commonly not available in clinical routine and, hence, at large scale. The purpose of this study was to detect MS-related damage of NAWM by conventional MRI. As, within NAWM, the myelin content mainly drives the T1-weighted (T1w) signal, we scaled it by the T2w signal. We tested the hypothesis that the mean T1w/T2w ratio of NAWM is decreased in MS compared to healthy controls (HC) and that it correlates with clinical measures. We developed a pipeline to determine the individual mean values of this ratio within NAWM. We studied 244 patients in early disease stages of MS (mean age 37 +/- A 10 years, mean disease duration 3.1 +/- A 2.3, Expanded Disability Status Scale 1.3 +/- A 1), and 78 HC (mean age 31 +/- A 8 years). Compared to HC, the mean T1w/T2w ratio was lowered in the patient group (P < 0.001). The difference remained significant after restricting the analysis to patients with a disease duration of 5 years or less and without disease modifying drugs. Our measures also correlated with clinical scores. We believe that the mean T1w/T2w ratio is a promising candidate to assess MS-related tissue damage within NAWM at large scale.