MAGNETIC-RESONANCE-IMAGING LESION ENLARGEMENT IN MULTIPLE-SCLEROSIS - DISEASE-RELATED ACTIVITY, CHANCE OCCURRENCE, OR MEASUREMENT ARTIFACT
MAGNETIC-RESONANCE-IMAGING LESION ENLARGEMENT IN MULTIPLE-SCLEROSIS - DISEASE-RELATED ACTIVITY, CHANCE OCCURRENCE, OR MEASUREMENT ARTIFACT
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DOI：
10.1001/archneur.1992.00530270075021
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发表时间：
1992-03-01
影响因子：
--
通讯作者：
RUDICK, RA
中科院分区：
文献类型：
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作者：
GOODKIN, DE;ROSS, JS;RUDICK, RA
磁共振成像（MRI）可以通过多种方式显示多发性硬化患者的疾病活动。新出现的MRI病变、钆增强病变和原有病变的扩大常被视为疾病活动性的证据。此外，系列MRI研究在检测疾病活动性方面比重复的神经系统检查更敏感。我们通过重复测量4例多发性硬化患者的所有MRI病灶面积，评估了使用病灶扩大作为疾病活动性衡量标准的有效性。所有患者的大小-频率分布相似，80%的病变测量值小于0.67 cm 2。三次连续病灶测量的中位变异系数与病灶面积呈负相关，范围从更常见的较小病灶（< 0.67 cm 2）的22.6%到较大病灶的12.1%。基于这些变异系数，应要求特定病变的变化超过45.2%（基线病变小于0.67 cm 2）和24.2%（基线病变大于或等于0.67 cm 2），以排除测量变异性引起的变化。当基线MRI中存在多个病变时，仍有必要确定必须改变的病变数量，以便在确定MRI明显疾病活动时可靠地排除偶然发生。确定这些标准的指导方针，是固有的局限性，在统计模型，使这些决定。
Magnetic resonance imaging (MRI) may demonstrate disease activity in a number of ways in patients with multiple sclerosis. Newly appearing MRI lesions, gadolinium-enhancing lesions, and enlargement of preexisting lesions are frequently taken as evidence of disease activity. Furthermore, serial MRI studies have been stated to be more sensitive than repeated neurologic examinations in detecting disease activity. We assessed the validity of using lesion enlargement as a measure of disease activity by repeatedly measuring the area of all MRI lesions in four patients with multiple sclerosis. The size-frequency distribution in all patients was similar, with 80% of the lesions measuring less than 0.67 cm2. The median coefficient of variation for three successive lesion measurements was inversely related to lesion area, ranging from 22.6% for the more common smaller lesions (< 0.67 cm2) to 12.1% for larger lesions. Based on these coefficients of variation, a change in a particular lesion exceeding 45.2% for a baseline lesion smaller than 0.67 cm2 and 24.2% for a baseline lesion greater than or equal to 0.67 cm2 should be required to exclude a change due to measurement variability. It remains necessary to determine the number of lesions that must change when multiple lesions are present in the baseline MRI to reliably exclude chance occurrence when establishing MRI-evident disease activity. Guidelines for determining these criteria are presented, as are the limitations inherent in the statistical model employed to make these determinations.