3.0T MRI 并不改善多发性硬化症的诊断：一项多中心研究。
Three-Tesla MRI does not improve the diagnosis of multiple sclerosis: A multicenter study.
机构信息
From the Departments of Neurology (M.H.J.H., J.B., J.K.) and Radiology and Nuclear Medicine (I.D.K., M.L.d.V., M.P.W., F.B.), MS Centre Amsterdam, and Department of Epidemiology and Biostatistics (B.I.L.-W.), VU University Medical Centre; Department of Radiology and Nuclear Medicine (I.D.K.), Onze Lieve Vrouwen Gasthuis, Amsterdam, the Netherlands; Queen Square Multiple Sclerosis Centre (N.C., O.C.) and Institutes of Neurology & Healthcare Engineering (F.B.), UCL Institute of Neurology, London, UK; Department of Neurology and Psychiatry (E.S., P.P.), Sapienza University of Rome, Italy; Department of Neurology (M. Andelova, M. Amann) and Division of Neuroradiology, Department of Radiology (M. Amann, J.M.L.), University Hospital Basel; Medical Image Analysis Centre (M. Amann), Basel, Switzerland; Istituto Neurologico Mediterraneo (P.P.), Neuromed, Pozzilli (IS), Italy; Department of Neurology (C.O.-G.), Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain; National Institute for Health Research (O.C., F.B.), University College London Hospitals (UCLH) Biomedical Research Centre (BRC), UK; Department of Neurosciences (C.G.), San Camillo-Forlanini Hospital, Rome, Italy; and Department of Diagnostic and Interventional Radiology and Nuclear Medicine (C.L.), St. Josef Hospital, Ruhr University, Bochum, Germany.
出版信息
Neurology. 2018 Jul 17;91(3):e249-e257. doi: 10.1212/WNL.0000000000005825. Epub 2018 Jun 20.
OBJECTIVE
In the work-up of patients presenting with a clinically isolated syndrome (CIS), 3T MRI might offer a higher lesion detection than 1.5T, but it remains unclear whether this affects the fulfilment of the diagnostic criteria for multiple sclerosis (MS).
METHODS
We recruited 66 patients with CIS within 6 months from symptom onset and 26 healthy controls in 6 MS centers. All participants underwent 1.5T and 3T brain and spinal cord MRI at baseline according to local optimized protocols and the MAGNIMS guidelines. Patients who had not converted to MS during follow-up received repeat brain MRI at 3-6 months and 12-15 months. The number of lesions per anatomical region was scored by 3 raters in consensus. Criteria for dissemination in space (DIS) and dissemination in time (DIT) were determined according to the 2017 revisions of the McDonald criteria.
RESULTS
Three-Tesla MRI detected 15% more T2 brain lesions compared to 1.5T ( 0.001), which was driven by an increase in baseline detection of periventricular (12%, 0.015), (juxta)cortical (21%, 0.005), and deep white matter lesions (21%, 0.001). The detection rate of spinal cord lesions and gadolinium-enhancing lesions did not differ between field strengths. Three-Tesla MRI did not lead to a higher number of patients fulfilling the criteria for DIS or DIT, or subsequent diagnosis of MS, at any of the 3 time points.
CONCLUSION
Scanning at 3T does not influence the diagnosis of MS according to McDonald diagnostic criteria.
目的
在临床表现孤立综合征（CIS）患者的检查中，3T MRI 可能比 1.5T 检测到更多的病变，但尚不清楚这是否会影响多发性硬化症（MS）的诊断标准的满足情况。
方法
我们在 6 个 MS 中心招募了 66 名 CIS 患者（发病后 6 个月内）和 26 名健康对照者。所有参与者均根据当地优化的方案和 MAGNIMS 指南，在基线时接受 1.5T 和 3T 脑和脊髓 MRI 检查。在随访期间未转化为 MS 的患者在 3-6 个月和 12-15 个月时接受重复脑 MRI 检查。3 名评分者通过共识对每个解剖区域的病变数量进行评分。根据 2017 年 McDonald 标准修订版确定空间传播（DIS）和时间传播（DIT）标准。
结果
与 1.5T 相比，3T MRI 检测到的 T2 脑病变多 15%（ 0.001），这主要是由于脑室周围（12%， 0.015）、（皮质旁）（21%， 0.005）和深部白质病变（21%， 0.001）的基线检测增加。脊髓病变和钆增强病变的检测率在不同场强之间没有差异。在任何 3 个时间点，3T MRI 均未导致更多患者符合 DIS 或 DIT 标准或随后诊断为 MS。
结论
根据 McDonald 诊断标准，3T 扫描不会影响 MS 的诊断。
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