Normalized regional brain atrophy measurements in multiple sclerosis
Normalized regional brain atrophy measurements in multiple sclerosis
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DOI：
10.1007/s00234-003-1101-2
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发表时间：
2003-11-01
期刊：
影响因子：
2.8
通讯作者：
Zorzon, M
中科院分区：
文献类型：
--
作者：
Zivadinov, R;Locatelli, L;Zorzon, M
在多发性硬化（MS）研究中，关于最佳局部脑萎缩测量方法仍存在争议。本研究的目的是确定在横断面研究中，区域性脑萎缩的标准化测量值与MRI定义的区域性脑病变的相关性是否优于区域性脑萎缩的绝对测量值。我们评估了45例临床确诊的复发缓解型（RR）MS患者（中位病程12年），并使用可重复的半自动技术测量了额叶和脑桥的T1-病变负荷（LL）和T2-LL。额叶和脑桥的局部脑实质体积（RBPV）是通过使用一个计算机交互式程序，其中包括半自动和自动分割过程。标准化测量，区域脑实质分数（RBPF），计算为RBPV与额叶和脑桥区域脑实质和脑脊液（CSF）总体积的比值。总区域脑体积分数（TRBVF）是在我们对脑实质的总体积和额叶和脑桥区域的CSF对颅内总体积进行校正后获得的。脑桥RBPF的平均变异系数（CV）为观察者内重现性1%，观察者间重现性1.4%。一般来说，局部脑萎缩的标准化测量与局部脑容量和残疾的相关性优于绝对测量。RBPF和TRBVF与脑桥T2-LL相关（r=-0.37，P =0.011; r=-0.40，P =0.0005），与脑桥T1-LL相关（r=-0.27，P =0.046; r=-0.31，P =0.04），而RBPV与桥脑T1-LL无关（r=-0.18，P = NS）。额叶T1-LL与RBPF（r=-0.32，P =0.033）和TRBVF（r=-0.29，P =0.05）相关，与RBPV无关（R=-0.27，P = NS）。额叶T2-LL与RBPF（r=-0.27，P =0.06）、TRBVF（r=-0.28，P =0.057）有相关趋势，与RBPV无相关性（r=-0.23，P = NS）。扩展残疾状态量表（EDSS）和脑桥和额叶RBPF和TRBVF之间的相关性的幅度是两倍以上的EDSS和RBPV的相同区域之间的相关性。这些数据表明，在横断面研究中，标准化的局部脑萎缩测量比绝对的局部测量更可取。
There is still a controversy regarding the best regional brain atrophy measurements in multiple sclerosis (MS) studies. The aim of this study was to establish whether, in a cross-sectional study, the normalized measurements of regional brain atrophy correlate better with the MRI-defined regional brain lesions than the absolute measurements of regional brain atrophy. We assessed 45 patients with clinically definite relapsing-remitting (RR) MS (median disease duration 12 years), and measured T1-lesion load (LL) and T2-LL of frontal lobes and pons, using a reproducible semi-automated technique. The regional brain parenchymal volume (RBPV) of frontal lobes and pons was obtained by use of a computerized interactive program, which incorporates semi-automated and automated segmentation processes. A normalized measurement, the regional brain parenchymal fraction (RBPF), was calculated as the ratio of RBPV to the total volume of the parenchyma and the cerebrospinal fluid (CSF) in the frontal lobes and in the region of the pons. The total regional brain volume fraction (TRBVF) was obtained after we had corrected for the total volume of the parenchyma and the CSF in the frontal lobes and in the region of the pons for the total intracranial volume. The mean coefficient of variation (CV) for RBPF of the pons was 1% for intra-observer reproducibility and 1.4% for inter-observer reproducibility. Generally, the normalized measurements of regional brain atrophy correlated with regional brain volumes and disability better than did the absolute measurements. RBPF and TRBVF correlated with T2-LL of the pons (r=-0.37, P=0.011, and r= -0.40, P=0.0005 respectively) and with T1-LL of the pons (r=-0.27, P=0.046, and r=-0.31, P=0.04, respectively), whereas RBPV did not (r=-0.18, P = NS). T1-LL of the frontal lobes was related to RBPF (r=-0.32, P=0.033) and TRBVF (r=-0.29, P=0.05), but not to RBPV (R=-0.27, P= NS). There was only a trend of correlation between T2-LL of the frontal lobes and RBPF (r=-0.27, P=0.06) and TRBVF (r=-0.28, P=0.057), and no correlation with RBPV (r=-0.23, P= NS). The magnitude of correlation between the expanded disability status scale (EDSS) and pontine and frontal lobe RBPF and TRBVF was more than twice as high as the correlation between EDSS and RBPV of the same regions. These data suggest that normalized regional brain atrophy measurements are preferable to absolute regional measurements in cross-sectional studies.