Three-Tesla MRI does not improve the diagnosis of multiple sclerosis: A multicenter study.
Three-Tesla MRI does not improve the diagnosis of multiple sclerosis: A multicenter study.
复制标题
DOI：
10.1212/wnl.0000000000005825
复制
发表时间：
2018-07-17
期刊：
影响因子：
9.9
通讯作者：
MAGNIMS Study Group
中科院分区：
文献类型：
--
作者：
Hagens MHJ;Burggraaff J;Kilsdonk ID;de Vos ML;Cawley N;Sbardella E;Andelova M;Amann M;Lieb JM;Pantano P;Lissenberg-Witte BI;Killestein J;Oreja-Guevara C;Ciccarelli O;Gasperini C;Lukas C;Wattjes MP;Barkhof F;MAGNIMS Study Group
在临床孤立综合征（CIS）患者的检查中，3T MRI可能提供比1.5T更高的病变检出率，但尚不清楚这是否会影响多发性硬化症（MS）诊断标准的实现。我们在6个MS中心招募了66名症状出现后6个月内患有CIS的患者和26名健康对照者。根据局部优化方案和MAGNIMS指南，所有参与者在基线时接受1.5T和3T脑和脊髓MRI检查。随访期间未转为多发性硬化症的患者在3-6个月和12-15个月再次接受脑MRI。每个解剖区域的病变数量由3个评分者一致评分。空间传播（DIS）和时间传播（DIT）标准是根据2017年麦当劳标准的修订版确定的。与1.5T相比，3 -特斯拉MRI检测到的T2脑病变增加了15% (p < 0.001)，这是由于基线检测到的脑室周围（12%,p = 0.015）、皮质（近区）（21%,p = 0.005）和深部白质病变（21%,p < 0.001）增加所致。脊髓病变和钆增强病变的检出率在场强之间没有差异。三特斯拉MRI在三个时间点中的任何一个都没有导致更多的患者满足DIS或DIT的标准，或随后诊断为MS。根据McDonald诊断标准，3T扫描不影响MS的诊断。
In the work-up of patients presenting with a clinically isolated syndrome (CIS), 3T MRI might offer a higher lesion detection than 1.5T, but it remains unclear whether this affects the fulfilment of the diagnostic criteria for multiple sclerosis (MS). We recruited 66 patients with CIS within 6 months from symptom onset and 26 healthy controls in 6 MS centers. All participants underwent 1.5T and 3T brain and spinal cord MRI at baseline according to local optimized protocols and the MAGNIMS guidelines. Patients who had not converted to MS during follow-up received repeat brain MRI at 3–6 months and 12–15 months. The number of lesions per anatomical region was scored by 3 raters in consensus. Criteria for dissemination in space (DIS) and dissemination in time (DIT) were determined according to the 2017 revisions of the McDonald criteria. Three-Tesla MRI detected 15% more T2 brain lesions compared to 1.5T (p < 0.001), which was driven by an increase in baseline detection of periventricular (12%, p = 0.015), (juxta)cortical (21%, p = 0.005), and deep white matter lesions (21%, p < 0.001). The detection rate of spinal cord lesions and gadolinium-enhancing lesions did not differ between field strengths. Three-Tesla MRI did not lead to a higher number of patients fulfilling the criteria for DIS or DIT, or subsequent diagnosis of MS, at any of the 3 time points. Scanning at 3T does not influence the diagnosis of MS according to McDonald diagnostic criteria.