Progressive cerebral atrophy in MS - A serial study using registered, volumetric MRI
Progressive cerebral atrophy in MS - A serial study using registered, volumetric MRI
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DOI：
10.1212/wnl.54.4.807
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发表时间：
2000-02-22
期刊：
影响因子：
9.9
通讯作者：
Thompson, AJ
中科院分区：
文献类型：
--
作者：
Fox, NC;Jenkins, R;Thompson, AJ
目的：评估配准体积 MRI 在测量 MS 萎缩率方面的潜力。背景：病理学和影像学研究表明，多发性硬化症中永久性神经损伤的发生与进行性脑和脊髓萎缩有关。萎缩被认为是疾病进展的潜在标志。传统的萎缩测量需要手动勾画轮廓，非常耗时且存在重现性问题。连续 MRI 的记录可能提供一种有用的替代方案，因为可以通过自动减去脑体积来直接测量脑损失。方法：26 名多发性硬化症患者和 26 名年龄和性别匹配的对照者进行了两次相隔 1 年的体积脑部 MR 研究。使用半自动技术测量基线大脑和心室体积，并将后续扫描记录到基线。脑萎缩率直接根据记录的扫描计算。结果：与对照组相比，MS 组的基线脑体积较小（平均差异 78 mL [95% CI 13 至 143；p = 0.02]），而脑室体积较大（平均差异 12 mL [95% CI 6 至 18；p < 0.001]）。 MS 组的脑萎缩率（每年 0.8%）是对照组（0.3%）的两倍多，脑室扩大率是对照组的五倍（1.6 毫升/年 vs 0.3 毫升/年）。结论：进行性脑萎缩是MS的重要特征。基于配准的测量结果灵敏且可重复，可以在一年内检测到进行性萎缩，并且有可能作为监测治疗试验中进展的标志物。
Objective: To assess the potential of registered volumetric MRI in measuring rates of atrophy in MS. Background: Pathologic and imaging studies suggest that the development of permanent neurologic impairment in MS is associated with progressive brain and spinal cord atrophy. Atrophy has been suggested as a potential marker of disease progression. Conventional atrophy measurements requiring manual outlining are time-consuming and subject to reproducibility problems. Registration of serial MRI may offer a useful alternative in that cerebral losses may be measured directly from automated subtraction of brain volumes. Methods: Twenty-six patients with MS and 26 age- and gender-matched controls had two volumetric brain MR studies 1 year apart. Baseline brain and ventricular volumes were measured using semiautomated techniques, and follow-up scans were registered to baseline. Rates of cerebral atrophy were calculated directly from the registered scans. Results: Baseline brain volumes in the MS group were smaller (mean difference 78 mL [95% CI 13 to 143; p = 0.02]) and ventricular volumes greater (mean difference 12 mL [95% CI 6 to 18; p < 0.001]) than controls. The rate of cerebral atrophy in the MS group (0.8% per year) was over twice that of controls (0.3%), and the rate of ventricular enlargement was five times greater than the controls (1.6 versus 0.3 mL/year). Conclusion: Progressive cerebral atrophy is an important feature of MS. Registration-based measurements are sensitive and reproducible, allowing progressive atrophy to be detected within 1 year and may have potential as a marker of progression in monitoring therapeutic trials.