Predictors of long-term disability in multiple sclerosis patients using routine magnetic resonance imaging data: A 15-year retrospective study.
Predictors of long-term disability in multiple sclerosis patients using routine magnetic resonance imaging data: A 15-year retrospective study.
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使用常规磁共振成像数据预测多发性硬化症患者长期残疾：一项15年回顾性研究。
DOI：
10.1177/19714009221150853
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发表时间：
2023-10
期刊：
影响因子：
--
通讯作者：
Evangelou N
中科院分区：
文献类型：
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作者：
Altokhis A;Alotaibi A;Morgan P;Tanasescu R;Evangelou N
早期识别进展高风险的患者有助于制定个性化治疗策略。磁共振成像（MRI）措施已被提议用于预测多发性硬化症（MS）的长期残疾，但仍然需要一种可以在临床上轻松实施的可靠预测指标。评估多发性硬化症病程前 5 年的 MRI 测量结果，以预测 10 年以上疾病进展的能力。 82 名多发性硬化症患者（53 名女性）进行了 10 年以上的临床随访，并进行了两次 MRI 扫描。临床数据是在基线、随访和≥10 年时获得的。在 T2/FLAIR“流体衰减反转恢复”和 T1 加权图像上测量白质病变 (WML) 计数和体积以及四个线性大脑尺寸。基线和随访尾状核间直径 (ICD) 和第三脑室宽度 (TVW) 测量值与扩展残疾状态量表呈正相关，≥10 或更多的 WML 在预测≥10 年的进展方面表现出高度敏感性。在转为继发性进行性多发性硬化症的受试者中观察到病变体积增加的速度更快。 ICD 和 TVW 预测 10 岁以上残疾的敏感性和特异性分别为 60% 和 64%。尽管脑成像和计算机体积分析取得了进步，但 ICD 和 TVW 仍然具有相关性，因为它们简单、快速并且具有预测长期残疾的潜力。然而，在这项研究中，尽管这些措施具有统计学意义，但临床效用仍然不可靠。
Early identification of patients at high risk of progression could help with a personalised treatment strategy. Magnetic resonance imaging (MRI) measures have been proposed to predict long-term disability in multiple sclerosis (MS), but a reliable predictor that can be easily implemented clinically is still needed. Assess MRI measures during the first 5 years of the MS disease course for the ability to predict progression at 10+ years. Eighty-two MS patients (53 females), with ≥10 years of clinical follow-up and having two MRI scans, were included. Clinical data were obtained at baseline, follow-up and at ≥10 years. White matter lesion (WML) counts and volumes, and four linear brain sizes were measured on T2/FLAIR ‘Fluid-Attenuated-Inversion-Recovery’ and T1-weighted images. Baseline and follow-up inter-caudate diameter (ICD) and third ventricular width (TVW) measures correlated positively with Expanded Disability Status Scale, ≥10 or more of WMLs showed a high sensitivity in predicting progression, at ≥10 years. A steeper rate of lesion volume increase was observed in subjects converting to secondary progressive MS. The sensitivity and specificity of both ICD and TVW, to predict disability at ≥10 years were 60% and 64%, respectively. Despite advances in brain imaging and computerised volumetric analysis, ICD and TVW remain relevant as they are simple, fast and have the potential in predicting long-term disability. However, in this study, despite the statistical significance of these measures, the clinical utility is still not reliable.