MR spectroscopy (MRS) and magnetisation transfer imaging (MTI), lesion load and clinical scores in early relapsing remitting multiple sclerosis: a combined cross-sectional and longitudinal study
MR spectroscopy (MRS) and magnetisation transfer imaging (MTI), lesion load and clinical scores in early relapsing remitting multiple sclerosis: a combined cross-sectional and longitudinal study
复制标题
DOI：
10.1007/s00330-009-1364-z
复制
发表时间：
2009-08-01
影响因子：
5.9
通讯作者：
Klingebiel, R.
中科院分区：
文献类型：
--
作者：
Bellmann-Strobl, J.;Stiepani, H.;Klingebiel, R.
本研究的目的是将基于磁共振成像（MRI）的病变负荷评估与早期复发缓解型多发性硬化（RRMS）的临床残疾相关联。纳入17例初次诊断为RRMS的未治疗患者（10例女性，7例男性;平均年龄33.0 ± 7.9岁），与年龄匹配的健康对照组进行横断面以及纵向（24个月）临床和基于MRI的评估。常规MR序列、磁共振波谱（MRS）和磁化传递成像（MTI）均在1.5T下进行。病变数量和体积、MRS和MTI测量的病变和外观正常的白色物质（NAWM）与临床评分[扩展残疾状态量表（EDSS）、多发性硬化功能复合评分（MSFC）]相关，用于监测治疗开始后的病程（干扰素β-1 a）。MTI和MRS检测NAWM随时间的变化[磁化转移率（MTR），N-乙酰天冬氨酸（NAA）/肌酸比值]。EDSS和病变MTR增加在整个疾病过程中相关。NAWM的平均MTR在研究期间升高（p < 0.05），并且与MSFC评分相关（r = 0.476，p < 0.001）。研究结束时，NAWM的NAA/肌酸比与MSFC评分相关（p < 0.05）。MTI和MRS对NAWM的初始疾病评估是有用的。MTI和MRS与临床评分相关，表明监测疾病进程和获得治疗相关效应的新见解的潜力。
The purpose of this study was to correlate magnetic resonance imaging (MRI)-based lesion load assessment with clinical disability in early relapsing remitting multiple sclerosis (RRMS). Seventeen untreated patients (ten women, seven men; mean age 33.0 +/- 7.9 years) with the initial diagnosis of RRMS were included for cross-sectional as well as longitudinal (24 months) clinical and MRI-based assessment in comparison with age-matched healthy controls. Conventional MR sequences, MR spectroscopy (MRS) and magnetisation transfer imaging (MTI) were performed at 1.5 T. Lesion number and volume, MRS and MTI measurements for lesions and normal appearing white matter (NAWM) were correlated to clinical scores [Expanded Disability Status Scale (EDSS), Multiple Sclerosis Functional Composite (MSFC)] for monitoring disease course after treatment initiation (interferon beta-1a). MTI and MRS detected changes [magnetisation transfer ratio (MTR), N-acetylaspartate (NAA)/creatine ratio] in NAWM over time. EDSS and lesional MTR increases correlated throughout the disease course. Average MTR of NAWM raised during the study (p < 0.05) and correlated to the MSFC score (r = 0.476, p < 0.001). At study termination, NAA/creatine ratio of NAWM correlated to the MSFC score (p < 0.05). MTI and MRS were useful for initial disease assessment in NAWM. MTI and MRS correlated with clinical scores, indicating potential for monitoring the disease course and gaining new insights into treatment-related effects.