Minneboo A, Uitdehaag B M J, Jongen P, Vrenken H, Knol D l, van Walderveen M A A, Polman C H, Castelijns J A, Barkhof F
Department of Radiology, MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
Mult Scler. 2009 May;15(5):632-7. doi: 10.1177/1352458509102617.
Several magnetic resonance imaging (MRI) parameters are known to be associated with short-term outcome in multiple sclerosis (MS) patients. MS-related disability typically progresses over decades, stressing the need for longer follow-up studies. Until now, these studies are relatively sparse and, therefore, the predictive value of MRI parameters for clinical disability remains largely unknown.
To assess the predictive value of brain MRI parameters, which are obtained during the first 3.3 years of the study for overall disease severity as measured by the MS Severity Score (MSSS) after 12.2 years follow-up.
Forty-six MS patients were included in the study. MRI parameters included both lesion loads and atrophy measures. Average and change parameters were calculated for MRI parameters and subsequently used as independent variables in regression models, while MSSS was the dependent variable.
Follow-up (FU) was obtained in 43/46 patients (94%) and median expanded disability status scale (EDSS) score increased significantly from 2.5 to 4.0. At last FU median MSSS was 4.3 (range 2.2-6.9). In univariate analyses, both change and cross-sectional T1-hypointense lesion load and ventricular atrophy measures were associated with MSSS. A multiple regression model included the change parameter of hypointense T1-lesion load (BHLL). This model explained 20% of variance in MSSS, which increased to 34% when type of disease (relapsing remitting or secondary progressive), age, and sex were entered additionally.
MRI measures of axonal loss are associated with higher overall disease severity in MS patients.
已知多种磁共振成像（MRI）参数与多发性硬化症（MS）患者的短期预后相关。MS相关的残疾通常会在几十年间逐渐发展，这凸显了进行更长时间随访研究的必要性。到目前为止，这些研究相对较少，因此，MRI参数对临床残疾的预测价值在很大程度上仍不明确。
评估在研究的前3.3年获得的脑MRI参数对随访12.2年后通过MS严重程度评分（MSSS）衡量的整体疾病严重程度的预测价值。
46例MS患者纳入本研究。MRI参数包括病灶负荷和萎缩测量值。计算MRI参数的平均值和变化参数，随后将其用作回归模型中的自变量，而MSSS为因变量。
46例患者中有43例（94%）获得随访，扩展残疾状态量表（EDSS）中位数评分从2.5显著增加至4.0。在最后一次随访时，MSSS中位数为4.3（范围2.2 - 6.9）。在单变量分析中，T1低信号病灶负荷的变化和横断面测量值以及脑室萎缩测量值均与MSSS相关。多元回归模型纳入了T1低信号病灶负荷（BHLL）的变化参数。该模型解释了MSSS中20%的方差，当额外纳入疾病类型（复发缓解型或继发进展型）、年龄和性别时，这一比例增加至34%。
MS患者轴突丢失的MRI测量值与更高的整体疾病严重程度相关。
