Infratentorial lesions predict long-term disability in patients with initial findings suggestive of multiple sclerosis
Infratentorial lesions predict long-term disability in patients with initial findings suggestive of multiple sclerosis
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DOI：
10.1001/archneur.61.2.217
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发表时间：
2004-02-01
影响因子：
--
通讯作者：
Castelijns, JA
中科院分区：
文献类型：
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作者：
Minneboo, A;Barkhof, F;Castelijns, JA
背景资料：在最初发现提示多发性硬化的患者中，基线脑磁共振图像异常的数量和体积已知可预测残疾的结局。目的：评估基线磁共振成像参数（包括病变位置、钆增强和低信号病变）对多发性硬化患者发生扩展残疾状态量表（Expanded Disability Status Scale）评分为3分的临床相关残疾的长期预测价值。患者：在平均8.7年的随访期后，对42例患者的病历进行了审查和评估，直到患者接受扩展残疾状态量表评分为3分。磁共振成像参数进行二分，根据最大的准确性，然后使用比例hazardratios.Results的考克斯模型计算风险比：转换为临床明确的多发性硬化症观察26例（62%），其中14（54%）进展到扩展残疾状态量表评分为3。两个或两个以上幕下病变最能预测长期残疾（风险比，6.3）。钆增强和低信号T1加权病变并没有显示预后value.Conclusion：小脑幕病变与长期预后的初步结果提示多发性硬化症患者，从而可能有助于确定患者在高风险的早期发生的临床相关残疾。
Background: The number and volume of abnormalities on baseline brain magnetic resonance images in patients with initial findings suggestive of multiple sclerosis are known to predict outcome in terms of disability. However, no long-term data exist on specific locations or types of lesions.Objective: To assess the long-term predictive value of baseline magnetic resonance imaging parameters, including location of lesions and gadolinium-enhancing and hypointense lesions in patients with initial findings suggestive of multiple sclerosis for the occurrence of clinically relevant disability as defined by an Expanded Disability Status Scale score of 3.Patients: After a median follow-up period of 8.7 years, the medical records of 42 patients were reviewed and assessed for time until patients received an Expanded Disability Status Scale score of 3. Magnetic resonance imaging parameters were dichotomized according to maximum accuracy and then used to calculate hazard ratios using the Cox model for proportional hazard ratios.Results: Conversion to clinically definite multiple sclerosis was observed in 26 patients (62%), of whom 14 (54%) progressed to an Expanded Disability Status Scale score of 3. Two or more infratentorial lesions best predicted long-term disability (hazard ratio, 6.3). Gadolinium-enhancing and hypointense T1-weighted lesions did not show prognostic value.Conclusion: Infratentorial lesions are related to long-term prognosis for patients with initial findings suggestive of multiple sclerosis and thus may help to identify patients at high risk for earlier occurrence of clinically relevant disability.