Brain lesion distribution criteria distinguish demyelinating diseases in China
Brain lesion distribution criteria distinguish demyelinating diseases in China
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中国区分脱髓鞘疾病的脑病变分布标准
DOI：
10.1002/acn3.50913
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发表时间：
2019-09-30
影响因子：
5.3
通讯作者：
Ding, Mei Ping
中科院分区：
文献类型：
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作者：
Cai, Meng-Ting;Zhang, Yin-Xi;Ding, Mei Ping
目的 验证脑病灶分布标准在中国人群中区分多发性硬化症（MS）、水通道蛋白 4（AQP4）-免疫球蛋白 G（IgG）阳性/阴性视神经脊髓炎谱系障碍（NMOSD）和髓磷脂少突胶质细胞糖蛋白 IgG 相关脑脊髓炎（MOG-EM）的实用性。方法 共纳入 253 例 MS（80 例）、NMOSD（129 例 AQP4-IgG 阳性，34 例 AQP4-IgG 阴性）和 MOG-EM（10 例）患者。匿名磁共振成像结果根据之前报告的标准进行评分：“至少有一个邻近侧脑室体部和下颞叶的病变；或存在皮质下 U 纤维病变；或道森手指型病变。”卡方检验（或费舍尔精确检验）用于分析数据。结果 分布标准能够以相同的敏感性将 MS 与所有类型的 NMOSD 和 MOG-EM 区分开来，均为 93.8%，整个 NMOSD 队列的特异性为 89.7%，AQP4-IgG 阳性 NMOSD 的特异性为 89.1%，AQP4-IgG 阴性 NMOSD 的特异性为 91.2%，MOG-EM 的特异性为 70.0%。 Dawson 的手指型病变是最敏感和最特异的特征，而 U 型纤维病变是最不敏感的。结论 脑部病变分布标准有助于区分中国人群中的 MS 与 NMOSD 和 MOG-EM。道森的手指型病变高度提示多发性硬化症。
Objective To verify the utility of brain lesion distribution criteria in distinguishing multiple sclerosis (MS) from aquaporin-4 (AQP4)-immunoglobulin G (IgG)-positive/-negative neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein IgG-associated encephalomyelitis (MOG-EM) in the Chinese population. Methods A total of 253 patients with MS (80), NMOSD (129 AQP4-IgG positive, 34 AQP4-IgG negative), and MOG-EM (10) were enrolled. Anonymized magnetic resonance imaging results were scored on the previous reported criteria of "at least one lesion adjacent to the body of the lateral ventricle and in the inferior temporal lobe; or the presence of a subcortical U-fiber lesion; or a Dawson's finger-type lesion." Chi-squared test (or Fisher's exact test) was used to analyze the data. Results The distribution criteria were able to distinguish MS with a same sensitivity of 93.8% from all type of NMOSD and MOG-EM, with a specificity of 89.7% from the whole NMOSD cohort, 89.1% from AQP4-IgG-positive NMOSD 91.2% from AQP4-IgG-negative NMOSD, and 70.0% from MOG-EM. Dawson's finger-type lesion was the most sensitive and specific feature, whereas the U-fiber lesion was the least. Conclusion The brain lesion distribution criteria were helpful in distinguishing MS from NMOSD and MOG-EM in the Chinese population. Dawson's finger-type lesion was highly suggestive of MS.