Yu Chun Shui, Zhu Chao Zhe, Li Kun Cheng, Xuan Yun, Qin Wen, Sun Hong, Chan Piu
Department of Radiology, Xuanwu Hospital, Capital University of Medical Sciences, 45 Chang-Chun St, Xuanwu District, Beijing 100053, People's Republic of China.
Radiology. 2007 Jul;244(1):249-56. doi: 10.1148/radiol.2441060930. Epub 2007 May 23.
To prospectively assess sensitivity and specificity of diffusion indexes of the corpus callosum (CC) for differentiating relapsing neuromyelitis optica (RNMO) from relapsing-remitting multiple sclerosis (RRMS), by using final clinical diagnosis as the reference standard.
Participants provided informed consent; the study was approved by the institutional review board. Forty-six consecutive patients with RRMS (18 men, 28 women; mean age, 37.7 years; range, 18-58 years) and 26 consecutive patients with RNMO (two men, 24 women; mean age, 38.6 years; range, 19-59 years) underwent diffusion-tensor magnetic resonance imaging. Mean diffusivity (MD) and fractional anisotropy (FA) of the region of interest (ROI) of the CC in the midsagittal plane were measured and used as discriminative indexes. Bayesian classification with leave-one-out cross-validation was used to determine diagnostic accuracy. Differences in diffusion indexes of ROIs among groups were evaluated by using the Kruskal-Wallis test, followed by the Mann-Whitney U test for multiple comparisons and Bonferroni correction.
Mean MD (8.48 x 10(-4) mm(2)/sec) and FA (0.729) of the ROI in patients with RNMO were significantly (P<.001) different from those (MD=10.64 x 10(-4) mm(2)/sec, FA=0.599) in patients with RRMS. Sensitivity and specificity for differentiation were 92.3% (24 of 26 patients with RNMO) and 93.5% (43 of 46 patients with RRMS) for FA and 88.5% (23 of 26 patients with RNMO) and 89.1% (41 of 46 patients with RRMS) for MD, respectively.
Measurement of diffusion indexes of the CC may be useful for distinguishing patients with RNMO from those with RRMS.
以前瞻性方式，以最终临床诊断为参考标准，评估胼胝体（CC）扩散指数对复发性视神经脊髓炎（RNMO）与复发缓解型多发性硬化症（RRMS）进行鉴别的敏感性和特异性。
参与者提供了知情同意书；该研究经机构审查委员会批准。46例连续的RRMS患者（18例男性，28例女性；平均年龄37.7岁；范围18 - 58岁）和26例连续的RNMO患者（2例男性，24例女性；平均年龄38.6岁；范围19 - 59岁）接受了扩散张量磁共振成像检查。测量矢状面中CC感兴趣区（ROI）的平均扩散率（MD）和分数各向异性（FA），并将其用作鉴别指标。采用留一法交叉验证的贝叶斯分类来确定诊断准确性。使用Kruskal - Wallis检验评估各组间ROI扩散指数的差异，随后使用Mann - Whitney U检验进行多重比较并进行Bonferroni校正。
RNMO患者ROI的平均MD（8.48×10⁻⁴ mm²/秒）和FA（0.729）与RRMS患者（MD = 10.64×10⁻⁴ mm²/秒，FA = 0.599）的显著不同（P <.001）。FA鉴别诊断的敏感性和特异性分别为92.3%（26例RNMO患者中的24例）和93.5%（46例RRMS患者中的43例），MD的敏感性和特异性分别为88.5%（26例RNMO患者中的23例）和89.1%（46例RRMS患者中的41例）。
测量CC的扩散指数可能有助于区分RNMO患者和RRMS患者。
