Morphology-Specific Discrimination between MS White Matter Lesions and Benign White Matter Hyperintensities Using Ultra-High-Field MRI
Morphology-Specific Discrimination between MS White Matter Lesions and Benign White Matter Hyperintensities Using Ultra-High-Field MRI
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DOI：
10.3174/ajnr.a5705
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发表时间：
2018-08-01
影响因子：
3.5
通讯作者：
Drangova, M.
中科院分区：
文献类型：
--
作者：
Hosseini, Z.;Matusinec, J.;Drangova, M.
背景和目的：最近发布的北美多发性硬化症影像学指南要求对 MS WM 病变和类似病变制定特定的放射学定义。本研究的目的是利用 SWI 和磁化准备的 FLAIR 图像，根据 WM 病变的形态特征，敏感地区分 MS 和良性 WM 病变。材料和方法：回顾性纳入 17 名复发缓解型多发性硬化症患者和 18 名健康对照受试者。对于每个受试者，使用 7T MR 成像获取 FLAIR 和多回波梯度回波图像。使用优化的后处理生成脑静脉的单切片 SWI。注册 SWI/FLAIR 图像，并由 3 名经过培训的读者进行病变评估。记录形态、病变位置和评估所需的时间。对 3 个不同的池进行分析：1）> 3 毫米的病变，2）> 3 毫米的非融合病变，以及 3）> 3 毫米的非融合病变，没有或只有一个中央静脉。结果：SWI/FLAIR 采集和处理协议能够有效评估 WM 病变的中央静脉和低信号边缘。使用 1 条中央静脉对非融合病变进行评估，能够最特异、最灵敏地将 MS 患者与对照组区分开来。 67% 的静脉周围 WM 病变阈值将 MS 患者与对照组区分开来，敏感性为 94%，特异性为 100%。 MS 患者和对照受试者的病变评估平均分别需要 12 分 10 秒和 4 分 33 秒。结论：大于 3 毫米且有 1 条中央静脉的不融合病变是 MS 患者和对照受试者之间最敏感和最特异的鉴别因素。
BACKGROUND AND PURPOSE:Recently published North American Imaging in Multiple Sclerosis guidelines call for derivation of a specific radiologic definition of MS WM lesions and mimics. The purpose of this study was to use SWI and magnetization-prepared FLAIR images for sensitive differentiation of MS from benign WM lesions using the morphologic characteristics of WM lesions. MATERIALS AND METHODS:Seventeen patients with relapsing-remitting MS and 18 healthy control subjects were enrolled retrospectively. For each subject, FLAIR and multiecho gradient-echo images were acquired using 7T MR imaging. Optimized postprocessing was used to generate single-slice SWI of cerebral veins. SWI/FLAIR images were registered, and 3 trained readers performed lesion assessment. Morphology, location of lesions, and the time required for assessment were recorded. Analyses were performed on 3 different pools: 1) lesions of >3 mm, 2) nonconfluent lesions of >3 mm, and 3) nonconfluent lesions of >3 mm with no or a single central vein. RESULTS:The SWI/FLAIR acquisition and processing protocol enabled effective assessment of central veins and hypointense rims in WM lesions. Assessment of nonconfluent lesions with 1 central vein enabled the most specific and sensitive differentiation of patients with MS from controls. A threshold of 67% perivenous WM lesions separated patients with MS from controls with a sensitivity of 94% and specificity of 100%. Lesion assessment took an average of 12 minutes 10 seconds and 4 minutes 33 seconds for patients with MS and control subjects, respectively. CONCLUSIONS:Nonconfluent lesions of >3 mm with 1 central vein were the most sensitive and specific differentiators between patients with MS and control subjects.