The Central Vein Sign in Multiple Sclerosis Lesions Is Present Irrespective of the T2*Sequence at 3 T
The Central Vein Sign in Multiple Sclerosis Lesions Is Present Irrespective of the T2*Sequence at 3 T
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DOI：
10.1111/jon.12367
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发表时间：
2017-01-01
影响因子：
2.4
通讯作者：
Evangelou, Nikos
中科院分区：
文献类型：
--
作者：
Samaraweera, Amal P. R.;Clarke, Margareta A.;Evangelou, Nikos
背景和目的：以前的T2* 加权磁共振成像（MRI）研究使用白色病变（WML）中央静脉来区分多发性硬化症（MS）与其模拟物。为了在临床上适用，“中央静脉征”需要在不同的T2* 序列中可检测到。我们的目的是确定中央静脉征是否可靠地存在于MS和缺血性小血管病（SVD）患者在不同的T2* 序列在3 T MRI。方法：10例MS和10例SVD患者分别扫描3 T Philips和GE扫描仪。MRI检查包括三维（3D）T2* GRE、T2* 高回波平面成像（EPI）因子和磁共振加权血管造影（SWAN）。使用每个序列计算总WML数量、中央静脉数量和具有中央静脉的WML比例。三个盲评分确定了一个子集的6个WMLs与中央静脉诊断MS或SVD.RESULTS：无论序列，MS患者确定的基础上更高比例的WMLs与中央静脉。该比例取决于所用的T2* 序列。高EPI的T2* 在MS患者中的中位比例最高（69.6%），在SVD患者中为6.1%（P <0.0004）。评分员再现性根据所用的T2* 序列而变化。具有高EPI的T2* 与临床诊断产生良好的一致性（Cohen的kappa范围; 0.78 - 0.89），与一些评定者的SWAN成像一样; Kappa = 69。结论：在现代3 T扫描仪的临床环境中，中央静脉征可以诊断MS。然而，在定义诊断阈值时，需要考虑T2* 序列的变化。
BACKGROUND AND PURPOSE: Previous T2*-weighted magnetic resonance imaging (MRI) studies have used white matter lesion (WML) central veins to distinguish multiple sclerosis (MS) from its mimics. To be clinically applicable, the "central vein sign" needs to be detectable across different T2* sequences. Our objective was to determine if the central vein sign is reliably present in MS and absent in patients with ischemic small vessel disease (SVD) across different T2* sequences at 3T MRI.METHODS: Ten patients with MS and 10 with SVD were each scanned on a 3 T Philips and GE scanner. The MRI protocol included 3-dimensional (3D) T2* GRE, T2* with high echo planar imaging (EPI) factor and susceptibility-weighted angiography (SWAN). Total WML numbers, central vein numbers, and proportion of WMLs with central veins were calculated using each sequence. Three blinded raters identified a subset of six WMLs with central veins to diagnose MS or SVD.RESULTS: Irrespective of the sequence, MS patients were identified based on a higher proportion of WMLs with central veins. This proportion was dependent on the T2* sequence used. T2* with high EPI allowed the highest median proportion (69.6%) in MS patients; 6.1% in SVD patients (P < .0004). Rater reproducibility varied depending on the T2* sequence used. T2* with high EPI produced good agreement with the clinical diagnosis (Cohen's kappa range;.78-.89), as did SWAN imaging with some raters;. kappa = 69.CONCLUSIONS: The central vein sign can diagnose MS in the clinical setting of modern 3T scanners. However, variations in the T2* sequences need to be considered when defining a threshold for diagnosis.