Department of Neurological and Behavioral Sciences, University of Siena, Siena, Italy.
Neurology. 2011 Nov 22;77(21):1896-9. doi: 10.1212/WNL.0b013e318238ee9b. Epub 2011 Nov 9.
To assess the presence of cortical lesions (CLs) as detected by MRI in subjects with radiologically isolated syndrome (RIS).
Fifteen subjects with RIS underwent an MRI examination, including a double inversion recovery sequence for CL assessment. T2-hyperintense white matter (WM) lesion volume (LV) and normalized volumes of brain and cortex were also obtained.
Thirty-four CLs were identified in 6 of 15 (40%) subjects with RIS and predominantly distributed in frontotemporal lobes. CLs were frequent in subjects with RIS with immunoglobulin G oligoclonal bands on CSF, cervical cord lesions, and dissemination in time on brain MRI. WM LV was higher in subjects with CLs than in those without CLs (11.5 ± 10.1 vs 3.9 ± 2.8 cm(3), p = 0.04). Indeed, CL number and volume correlated with WM LV (r = 0.57, p = 0.03 and r = 0.61, p = 0.01). All subjects with CLs were classified in a previous study as having a very high probability of having relapsing-remitting multiple sclerosis (MS) on a logistic regression analysis of quantitative MRI indices.
We found CLs in subjects with RIS, a condition characterized by the unanticipated MRI finding of WM lesions highly suggestive of MS in the absence of a clinical scenario. CLs were mainly localized to the frontotemporal lobes and were associated with important markers of evolution to MS.
评估磁共振成像（MRI）检测到的放射性孤立综合征（RIS）患者的皮质病变（CL）。
15 例 RIS 患者接受 MRI 检查，包括用于 CL 评估的双反转恢复序列。还获得了 T2 高信号白质（WM）病变体积（LV）和脑及皮质的归一化体积。
在 15 例 RIS 患者中有 6 例（40%）发现了 34 个 CL，主要分布在额颞叶。CL 在 CSF 中有免疫球蛋白 G 寡克隆带、颈髓病变和脑 MRI 上时间上弥散的 RIS 患者中更为常见。有 CL 的患者 WM LV 高于无 CL 的患者（11.5±10.1 比 3.9±2.8 cm³，p=0.04）。实际上，CL 数量和体积与 WM LV 相关（r=0.57，p=0.03 和 r=0.61，p=0.01）。在对定量 MRI 指数的逻辑回归分析中，所有有 CL 的患者都被归类为具有很高的复发缓解型多发性硬化（MS）的可能性。
我们在 RIS 患者中发现了 CL，这种疾病的特征是在没有临床情况下出现高度提示 MS 的 WM 病变的意外 MRI 发现。CL 主要位于额颞叶，与向 MS 演变的重要标志物相关。
