Berg Sebastian, Kaschka Iris, Utz Kathrin S, Huhn Konstantin, Lämmer Alexandra, Lämmer Robert, Waschbisch Anne, Kloska Stephan, Lee De-Hyung, Doerfler Arnd, Linker Ralf A
Department of Neurology, University Hospital Erlangen, University of Erlangen-Nuremberg, Erlangen, Germany.
Department of Neuroradiology, University Hospital Erlangen, University of Erlangen-Nuremberg, Erlangen, Germany.
PLoS One. 2015 Jan 30;10(1):e0113961. doi: 10.1371/journal.pone.0113961. eCollection 2015.
In acute optic neuritis, magnetic resonance imaging (MRI) may help to confirm the diagnosis as well as to exclude alternative diagnoses. Yet, little is known on the value of optic nerve imaging for predicting clinical symptoms or therapeutic outcome.
To evaluate the benefit of optic nerve MRI for predicting response to appropriate therapy and recovery of visual acuity.
Clinical data as well as visual evoked potentials (VEP) and MRI results of 104 patients, who were treated at the Department of Neurology with clinically definite optic neuritis between December 2010 and September 2012 were retrospectively reviewed including a follow up within 14 days.
Both length of the Gd enhancing lesion (r = -0.38; p = 0.001) and the T2 lesion (r = -0.25; p = 0.03) of the optic nerve in acute optic neuritis showed a medium correlation with visual acuity after treatment. Although visual acuity pre-treatment was little but nonsignificantly lower if Gd enhancement of the optic nerve was detected via orbital MRI, improvement of visual acuity after adequate therapy was significantly better (0.40 vs. 0.24; p = 0.04). Intraorbitally located Gd enhancing lesions were associated with worse visual improvement compared to canalicular, intracranial and chiasmal lesions (0.35 vs. 0.54; p = 0.02).
Orbital MRI is a broadly available, valuable tool for predicting the improvement of visual function. While the accurate individual prediction of long-term outcomes after appropriate therapy still remains difficult, lesion length of Gd enhancement and T2 lesion contribute to its prediction and a better short-term visual outcome may be associated with detection and localization of Gd enhancement along the optic nerve.
在急性视神经炎中，磁共振成像（MRI）有助于确诊并排除其他诊断。然而，关于视神经成像在预测临床症状或治疗结果方面的价值，人们所知甚少。
评估视神经MRI在预测适当治疗反应和视力恢复方面的益处。
回顾性分析了2010年12月至2012年9月间在神经内科接受临床确诊视神经炎治疗的104例患者的临床资料、视觉诱发电位（VEP）和MRI结果，随访时间为14天内。
急性视神经炎中视神经钆增强病变的长度（r = -0.38；p = 0.001）和T2病变（r = -0.25；p = 0.03）与治疗后的视力均呈中度相关。虽然通过眼眶MRI检测到视神经钆增强时，治疗前视力略低但无显著差异，但适当治疗后视力改善明显更好（0.40对0.24；p = 0.04）。与管内、颅内和视交叉病变相比，眶内钆增强病变的视力改善较差（0.35对0.54；p = 0.02）。
眼眶MRI是预测视觉功能改善的一种广泛可用且有价值的工具。虽然准确个体预测适当治疗后的长期结果仍然困难，但钆增强病变长度和T2病变有助于其预测，沿视神经钆增强的检测和定位可能与更好的短期视觉结果相关。
