Martola J, Stawiarz L, Fredrikson S, Hillert J, Bergström J, Flodmark O, Aspelin P, Wiberg M Kristoffersen
Division of Radiology, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.
Acta Radiol. 2009 Oct;50(8):924-32. doi: 10.1080/02841850903062732.
For decades, normalized one-dimensional (1D) measures have been used in the evaluation of brain atrophy. In multiple sclerosis (MS), the use of normalized linear measures over longitudinal follow-up remains insufficiently documented.
To evaluate the association between different regional atrophy measures and disability in MS patients over four decades in a longitudinal cross-sectional study.
37 consecutively selected MS patients were included. At baseline, patients had a range of disease duration (1-33 years) and age (24-65 years). Each patient was followed by magnetic resonance imaging (MRI) for a mean of 9.25 years (range 7.3-10 years). Four 1D measures were applied at three time points on axial 5-mm T1-weighted images. Three clinical MS subgroups were represented: relapsing-remitting MS (RRMS), secondary progressive MS (SPMS), and primary progressive MS (PPMS).
There were significant changes in all 1D ratios during follow-up. The Evans ratio (ER) and the bifrontal ratio (BFR) were associated with the development of disability. Changes of ER and BFR reflected more aggressive disease progression, as expressed by MS severity score (MSSS).
All four normalized ratios showed uniform atrophy progression, suggesting a consistent rate of atrophy over long-term disease duration independent of MS course. Disability status correlated with 1D measures, suggesting that serial evaluation of Evans and bifrontal ratios might contribute to the radiological evaluation of MS patients.
几十年来，标准化的一维（1D）测量方法一直用于脑萎缩的评估。在多发性硬化症（MS）中，纵向随访中使用标准化线性测量方法的记录仍不充分。
在一项纵向横断面研究中，评估40多年来MS患者不同区域萎缩测量值与残疾之间的关联。
纳入37例连续入选的MS患者。基线时，患者的病程范围为1至33年，年龄范围为24至65岁。每位患者平均接受磁共振成像（MRI）随访9.25年（范围7.3至10年）。在轴向5毫米T1加权图像的三个时间点应用四种一维测量方法。代表了三个临床MS亚组：复发缓解型MS（RRMS）、继发进展型MS（SPMS）和原发进展型MS（PPMS）。
随访期间所有一维比率均有显著变化。埃文斯比率（ER）和双额叶比率（BFR）与残疾的发展相关。ER和BFR的变化反映了更具侵袭性的疾病进展，如多发性硬化严重程度评分（MSSS）所示。
所有四个标准化比率均显示出一致的萎缩进展，表明在长期病程中萎缩率一致，与MS病程无关。残疾状态与一维测量值相关，这表明对埃文斯比率和双额叶比率的系列评估可能有助于MS患者的影像学评估。
