Filli Lukas, Hofstetter Louis, Kuster Pascal, Traud Stefan, Mueller-Lenke Nicole, Naegelin Yvonne, Kappos Ludwig, Gass Achim, Sprenger Till, Nichols Thomas E, Vrenken Hugo, Barkhof Frederik, Polman Chris, Radue Ernst-Wilhelm, Borgwardt Stefan J, Bendfeldt Kerstin
Medical Image Analysis Center, University Hospital Basel, Basel, Switzerland.
Mult Scler. 2012 Nov;18(11):1577-84. doi: 10.1177/1352458512442756. Epub 2012 Apr 11.
Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system. MS lesions show a typical distribution pattern and primarily affect the white matter (WM) in the periventricular zone and in the centrum semiovale.
To track lesion development during disease progression, we compared the spatiotemporal distribution patterns of lesions in relapsing-remitting MS (RRMS) and secondary progressive MS (SPMS).
We used T1 and T2 weighted MR images of 209 RRMS and 62 SPMS patients acquired on two different 1.5 Tesla MR scanners in two clinical centers followed up for 25 (± 1.7) months. Both cross-sectional and longitudinal differences in lesion distribution between RRMS and SPMS patients were analyzed with lesion probability maps (LPMs) and permutation-based inference.
MS lesions clustered around the lateral ventricles and in the centrum semiovale. Cross-sectionally, compared to RRMS patients, the SPMS patients showed a significantly higher regional probability of T1 hypointense lesions (p ≤ 0.03) in the callosal body, the corticospinal tract, and other tracts adjacent to the lateral ventricles, but not of T2 lesions (peak probabilities were RRMS: T1 9%, T2 18%; SPMS: T1 21%, T2 27%). No longitudinal changes of regional T1 and T2 lesion volumes between baseline and follow-up scan were found.
The results suggest a particular vulnerability to neurodegeneration during disease progression in a number of WM tracts.
多发性硬化症（MS）是一种中枢神经系统的慢性炎症性疾病。MS病变呈现典型的分布模式，主要影响脑室周围区域和半卵圆中心的白质（WM）。
为了追踪疾病进展过程中的病变发展情况，我们比较了复发缓解型MS（RRMS）和继发进展型MS（SPMS）中病变的时空分布模式。
我们使用了209例RRMS患者和62例SPMS患者的T1加权和T2加权MR图像，这些图像是在两个临床中心的两台不同的1.5特斯拉MR扫描仪上采集的，随访时间为25（±1.7）个月。使用病变概率图（LPMs）和基于排列的推理分析了RRMS和SPMS患者之间病变分布的横断面和纵向差异。
MS病变聚集在侧脑室周围和半卵圆中心。横断面分析显示，与RRMS患者相比，SPMS患者在胼胝体、皮质脊髓束和其他与侧脑室相邻的神经束中T1低信号病变的区域概率显著更高（p≤0.03），但T2病变的区域概率无显著差异（峰值概率分别为：RRMS：T1 9%，T2 18%；SPMS：T1 21%，T2 27%）。在基线扫描和随访扫描之间未发现区域T1和T2病变体积的纵向变化。
结果表明，在疾病进展过程中，一些白质神经束特别容易发生神经变性。
