Rovaris M, Filippi M
Neuroimaging Research Unit, Department of Neurology, Scientific Institute and University Hospital San Raffaele, Via Olgettina 60, I-20132 Milan, Italy.
Neurol Sci. 2005 Dec;26 Suppl 4:S204-8. doi: 10.1007/s10072-005-0515-5.
During the last two decades, conventional MRI (cMRI) has been extensively used in the diagnostic workup of multiple sclerosis (MS) patients, to monitor the natural history of the disease and to evaluate the efficacy of experimental treatments in randomised, controlled clinical trials. In the latter context, a major issue is represented by the high intra- and inter-individual heterogeneity of the MS patterns of disease activity and evolution. Such heterogeneity might explain, at least partially, the weak correlations found between clinical and cMRI aspects in patients with established MS, which is particularly evident when individual patients are considered. As a consequence, the definition of response to MS treatment, when based upon cMRI aspects, is still a challenging task. Although the use of cMRI-derived quantities as a standalone approach to define treatment options and strategies at an individual patient level should be discouraged, an evidence-based integration of clinical and cMRI data might be helpful in selected cases for an optimal work-up of patients undergoing immunomodulating or immunosuppressive treatments.
在过去二十年中，传统磁共振成像（cMRI）已广泛应用于多发性硬化症（MS）患者的诊断检查，以监测疾病的自然史，并在随机对照临床试验中评估实验性治疗的疗效。在后一种情况下，一个主要问题是MS疾病活动和演变模式在个体内和个体间存在高度异质性。这种异质性可能至少部分解释了已确诊MS患者临床和cMRI方面之间存在的弱相关性，在考虑个体患者时尤为明显。因此，基于cMRI方面来定义MS治疗反应仍然是一项具有挑战性的任务。虽然不应鼓励将cMRI衍生的指标作为在个体患者层面定义治疗方案和策略的独立方法，但在某些情况下，将临床和cMRI数据进行循证整合可能有助于对接受免疫调节或免疫抑制治疗的患者进行最佳检查。
