Zivadinov Robert, Leist Thomas P
Buffalo Neuroimaging Analysis Center, State University of New York at Buffalo, NY 14203, USA.
J Neuroimaging. 2005;15(4 Suppl):10S-21S. doi: 10.1177/1051228405283291.
Conventional magnetic resonance imaging (MRI) has routinely been used to improve the accuracy of multiple sclerosis (MS) diagnosis and monitoring, detect the effects of disease-modifying therapy, and refine the utility of clinical assessments. However, conventional MRI measures, such as the use of lesion volume and count of gadolinium-enhancing and T2 lesions, have insufficient sensitivity and specificity to reveal the true degree of pathological changes occurring in MS. Newer metrics of MRI analysis, including T1-weighted hypointense lesions (black holes) and central nervous system (CNS) atrophy measures, are able to capture a more global picture of the range of tissue alterations caused by inflammation, demyelination, axonal loss, and neurodegeneration. There is mounting evidence that these MRI measures correlate well with existing and developing neurological impairment and disability. In so doing, these MRI techniques can help elucidate the mechanisms underlying the pathophysiology and natural history of MS. The current understanding is that T1 black holes and CNS atrophy more accurately reflect the neurodegenerative and destructive components of the MS disease process. Therefore, the short and long-term studies that aim to measure the degree and severity of the neurodegenerative MS disease process should incorporate these MRI metrics as part of their standard routine MRI protocols.
传统磁共振成像（MRI）通常用于提高多发性硬化症（MS）诊断和监测的准确性，检测疾病修饰疗法的效果，并优化临床评估的效用。然而，传统的MRI测量方法，如使用病变体积以及钆增强和T2病变的数量，在揭示MS中发生的病理变化的真实程度方面，灵敏度和特异性不足。更新的MRI分析指标，包括T1加权低信号病变（黑洞）和中枢神经系统（CNS）萎缩测量，能够更全面地反映由炎症、脱髓鞘、轴突损失和神经变性引起的组织改变范围。越来越多的证据表明，这些MRI测量与现有的和正在发展的神经功能障碍和残疾密切相关。通过这样做，这些MRI技术可以帮助阐明MS病理生理学和自然史的潜在机制。目前的认识是，T1黑洞和CNS萎缩更准确地反映了MS疾病过程中的神经变性和破坏性成分。因此，旨在测量神经变性MS疾病过程的程度和严重性的短期和长期研究应将这些MRI指标纳入其标准常规MRI方案的一部分。
