Rovaris M, Inglese M, van Schijndel R A, Sormani M P, Rodegher M, Comi G, Filippi M
Neuroimaging Research Unit, Department of Neuroscience, Scientific Institute Ospedale San Raffaele, University of Milan, Via Olgettina, 60, 20132 Milan, Italy.
J Neurol. 2000 Dec;247(12):960-5. doi: 10.1007/s004150070054.
The course of multiple sclerosis (MS) can be monitored by measuring changes in brain volume, but consensus is still lacking on the best strategy to be adopted. We compared the reproducibility and sensitivity of volume measurements from different brain portions for detecting changes on magnetic resonance imaging (MRI) in patients with MS. T1-weighted MRI of the brain was performed in 50 patients with relapsing-remitting MS at study entry and after an average follow-up of 18.4 months. Using a semiautomated technique for brain parenchyma segmentation, the volumes of the following brain portions were measured: (a) the whole brain (whole-brain volume, WBV), (b) the seven slices rostral to the velum interpositum (seven-slice volume, SSV), (c) the central slice of the image set (central-slice volume, CSV) and (d) the infratentorial regions (infratentorial-brain volume, IBV). All these measurements were carried out by a single observer and were repeated twice on ten randomly selected scans to test the intra-observer reproducibility using the four strategies. At follow-up there was a significant decrease in all the measures of brain volume (P ranged from 0.002 to < 0.001). The univariate correlations between changes in WBV, SSV, CSV and IBV were all statistically significant, with the exception of that between changes in CSV and IBV; r values ranged from 0.34 (for the WBV/IBV correlation) to 0.80 (for the WBV/SSV correlation). The mean intra-observer coefficient of variations were 1.9% for WBV, 1.5% for SSV, 2.9% for CSV and 2.2% for IBV measurements. The measurement of volume on a portion of brain selectively including the regions in which MS pathology is more diffuse is as reliable and sensitive to disease-related changes as that on the whole brain, with significant time saving for processing.
多发性硬化症（MS）的病程可通过测量脑容量变化来监测，但对于应采用的最佳策略仍缺乏共识。我们比较了不同脑区容量测量在检测MS患者磁共振成像（MRI）变化方面的可重复性和敏感性。在研究开始时及平均随访18.4个月后，对50例复发缓解型MS患者进行了脑部T1加权MRI检查。使用半自动技术进行脑实质分割，测量了以下脑区的体积：（a）全脑（全脑体积，WBV），（b）松果体上方的七片脑区（七片脑区体积，SSV），（c）图像集的中央切片（中央切片体积，CSV），以及（d）幕下区域（幕下脑体积，IBV）。所有这些测量均由一名观察者进行，并在十次随机选择的扫描上重复两次，以使用这四种策略测试观察者内的可重复性。随访时，所有脑容量测量指标均显著下降（P值范围为0.002至<0.001）。WBV、SSV、CSV和IBV变化之间的单变量相关性均具有统计学意义，但CSV和IBV变化之间的相关性除外；r值范围从0.34（WBV/IBV相关性）至0.80（WBV/SSV相关性）。观察者内平均变异系数对于WBV测量为1.9%，对于SSV测量为1.5%，对于CSV测量为2.9%，对于IBV测量为2.2%。选择性地包括MS病理更弥漫区域的部分脑区的体积测量，对于疾病相关变化与全脑测量一样可靠且敏感，同时显著节省处理时间。
