Quantitative MRI for Analysis of Active Multiple Sclerosis Lesions without Gadolinium-Based Contrast Agent
Quantitative MRI for Analysis of Active Multiple Sclerosis Lesions without Gadolinium-Based Contrast Agent
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DOI：
10.3174/ajnr.a4501
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发表时间：
2016-01-01
影响因子：
3.5
通讯作者：
Larsson, E-M.
中科院分区：
文献类型：
--
作者：
Blystad, I.;Hakansson, I.;Larsson, E-M.
背景和目的：对比增强型多发性硬化症病变是多发性硬化症诊断检查和磁共振成像疾病监测中活动性炎症的重要标志物。因为静脉内造影剂涉及费用和不良事件的潜在风险，所以希望在不使用造影剂的情况下识别活动性病变。本研究的目的是通过使用新的定量 MR 成像序列，评估多发性硬化症病变的注射造影剂前组织松弛率和质子密度是否可以识别活动性病变。 材料和方法：对 44 名临床怀疑患有多发性硬化症的患者进行了研究。在纳入时（基线）和 1 年后使用标准临床 MS 方案和定量 MR 成像序列进行 MR 成像。 ROI 放置在 MS 病变中，分为非增强或增强。从定量 MR 成像序列中获得纵向和横向弛豫率以及质子密度。通过使用混合线性模型、逻辑回归和接受者操作特征分析对 ROI 值进行统计分析。结果：增强病灶具有显着 (P < .001) 较高的平均纵向松弛率（1.22 0.36 与 0.89 +/- 0.24）、较高的平均横向松弛率（9.8 +/- 2.6 与 7.4 +/- 1.9）和较低的平均质子密度（77 +/- 11.2 对比 90 +/- 8.4) 与非增强病变相比。受试者工作特征曲线下面积值为0.832。结论：增强MS病灶的质子密度和弛豫时间往往与非增强病灶不同，与非增强病灶相比，增强病灶质子密度较低，弛豫时间较短。
BACKGROUND AND PURPOSE: Contrast-enhancing MS lesions are important markers of active inflammation in the diagnostic work-up of MS and in disease monitoring with MR imaging. Because intravenous contrast agents involve an expense and a potential risk of adverse events, it would be desirable to identify active lesions without using a contrast agent. The purpose of this study was to evaluate whether pre-contrast injection tissue-relaxation rates and proton density of MS lesions, by using a new quantitative MR imaging sequence, can identify active lesions.MATERIALS AND METHODS: Forty-four patients with a clinical suspicion of MS were studied. MR imaging with a standard clinical MS protocol and a quantitative MR imaging sequence was performed at inclusion (baseline) and after 1 year. ROIs were placed in MS lesions, classified as nonenhancing or enhancing. Longitudinal and transverse relaxation rates, as well as proton density were obtained from the quantitative MR imaging sequence. Statistical analyses of ROI values were performed by using a mixed linear model, logistic regression, and receiver operating characteristic analysis.RESULTS: Enhancing lesions had a significantly (P < .001) higher mean longitudinal relaxation rate (1.22 0.36 versus 0.89 +/- 0.24), a higher mean transverse relaxation rate (9.8 +/- 2.6 versus 7.4 +/- 1.9), and a lower mean proton density (77 +/- 11.2 versus 90 +/- 8.4) than nonenhancing lesions. An area under the receiver operating characteristic curve value of 0.832 was obtained.CONCLUSIONS: Contrast-enhancing MS lesions often have proton density and relaxation times that differ from those in nonenhancing lesions, with lower proton density and shorter relaxation times in enhancing lesions compared with nonenhancing lesions.