Identification of Chronic Active Multiple Sclerosis Lesions on 3T MRI
Identification of Chronic Active Multiple Sclerosis Lesions on 3T MRI
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DOI：
10.3174/ajnr.a5660
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发表时间：
2018-07-01
影响因子：
3.5
通讯作者：
Reich, D. S.
中科院分区：
文献类型：
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作者：
Absinta, M.;Sati, P.;Reich, D. S.
磁共振成像病理研究报道，基于7T敏感性的磁共振成像上的顺磁边缘在体内识别出一部分MS病变，病变边缘有区隔性炎症，并伴有髓鞘再生失败。收集20例MS患者在3T和7T时的高分辨率T2*和期MR成像。在34个7T病变和36个3T病变中均可见期缘。在3T和7T分析中，评级间和评级内的信度都相当/良好。几乎所有的7T顺磁轮辋也可以在3T看到。3T成像开启了将顺磁环作为结果测量手段的可能性。背景和目的：磁共振成像病理研究报道，基于7T敏感性的磁共振成像上的顺磁边缘在体内识别出病变边缘有区隔性炎症和相关髓鞘再生失败的MS病变亚群。在这里，我们评估了在高分辨率3T相位图像上检测这些边缘的可靠性。材料与方法：收集20例MS患者在3T （3D分段EPI， 0.65 mm(3)）和7T (2D梯度回波，0.2 x 0.2 x 1 mm) MR成像的高分辨率T2*和相位MR成像。在每个病例中，在T2 FLAIR图像上选择5个离散的慢性（非增强）MS病变进行边缘评估。5名有MS成像经验的评分员参与了边缘评估，其中3人独立处理3T数据，2人独立处理7T数据。就3T和7T轮辋评估达成了共识。讨论了3T和7T之间的差异，并达成了共识。结果：在34例7T病变和36例3T病变中均可见期缘。在3T和7T分析中，内部和内部的信度都相当/良好（Cohen, >.71）。基于共识协议，3T和7T的边缘可视化的可靠性为0.78()，两两一致性为90%。与7T相比，3T时更多的病变被判断为假阳性或假阴性。结论：几乎所有的7T顺磁轮辋在3T也可以看到。在多中心、基于磁共振成像的临床试验中，3T成像开启了将顺磁环作为结果测量手段的可能性，这些临床试验旨在治疗病灶周围持续性炎症及其对髓鞘再生的潜在影响。
MR imaging-pathologic studies have reported that paramagnetic rims on 7T susceptibility-based MR imaging identify, in vivo, a subset of MS lesions with compartmentalized inflammation at the lesion edge and associated remyelination failure. High-resolution T2* and phase MR imaging were collected in 20 patients with MS at 3T and 7T. Phase rims were seen in 34 lesions at 7T and in 36 lesions at 3T by consensus. Inter- and intra-rater reliability were substantial/good both at 3T and 7T analysis. Nearly all 7T paramagnetic rims can also be seen at 3T. Imaging at 3T opens the possibility of implementing paramagnetic rims as an outcome measure.BACKGROUND AND PURPOSE: MR imaging-pathologic studies have reported that paramagnetic rims on 7T susceptibility-based MR imaging identify, in vivo, the subset of MS lesions with compartmentalized inflammation at the lesion edge and associated remyelination failure. Here, we assessed the reliability of detecting these rims on high-resolution 3T phase images.MATERIALS AND METHODS: High-resolution T2* and phase MR imaging was collected in 20 patients with MS at 3T (3D segmented EPI, 0.65 mm(3)) and 7T (2D gradient-echo, 0.2 x 0.2 x 1 mm) MR imaging. In each case, 5 discrete chronic (nonenhancing) MS lesions were selected on T2 FLAIR images for rim evaluation. Five raters experienced in MS imaging contributed to the rim assessment, of whom 3 worked independently on 3T data, and 2, on 7T data. Consensus agreement was reached for both 3T and 7T rim evaluations. Discrepancies between 3T and 7T were discussed, and consensus was reached.RESULTS: Phase rims were seen in 34 lesions at 7T and in 36 lesions at 3T by consensus. Inter- and intrarater reliability were substantial/good both at 3T and 7T analysis (Cohen , >0.71). Based on consensus agreement, the reliability of rim visualization at 3T versus 7T was 0.78 () with a pair-wise agreement of 90%. More lesions were judged to be false-positive or false-negative at 3T than at 7T.CONCLUSIONS: Nearly all 7T paramagnetic rims can also be seen at 3T. Imaging at 3T opens the possibility of implementing paramagnetic rims as an outcome measure in multicenter, MR imaging-based clinical trials aimed at treating perilesional persistent inflammation and its potential effects on remyelination.