应用短横向弛豫时间成分（ViSTa）髓鞘成像和梯度回波及自旋回波（GRASE）髓鞘成像直接可视化评估多发性硬化的正常表现白质。

Evaluation of Normal-Appearing White Matter in Multiple Sclerosis Using Direct Visualization of Short Transverse Relaxation Time Component (ViSTa) Myelin Water Imaging and Gradient Echo and Spin Echo (GRASE) Myelin Water Imaging.

机构信息

Laboratory for Imaging Science and Technology, Department of Electrical and Computer Engineering, Seoul National University, Seoul, Republic of Korea.

Department of Neurology, Research Institute and Hospital of National Cancer Center, Gyeonggi-do, Republic of Korea.

出版信息

J Magn Reson Imaging. 2019 Apr;49(4):1091-1098. doi: 10.1002/jmri.26278. Epub 2018 Sep 21.

DOI:10.1002/jmri.26278

PMID:30240519

Abstract

BACKGROUND

In multiple sclerosis (MS), not only lesions but also normal MRI-appearing white matter (NAWM) may undergo demyelination.

PURPOSE

To demonstrate the detection of NAWM demyelination using direct visualization of short transverse relaxation time component myelin water imaging (ViSTa-MWI) and to compare the results with those of conventional gradient echo and spin echo (GRASE)-MWI.

STUDY TYPE

Control/cohort.

POPULATION

Twenty-five MS patients and 18 healthy controls (HC).

FIELD STRENGTH/SEQUENCE: 3T/ViSTa and GRASE-MWI.

ASSESSMENT

Using ViSTa and GRASE-MWI, myelin water fraction (MWF) of NAWM or normal WM was compared between MS (all patients or early-stage MS patients) and HC. The comparison was performed for a global WM mask and five regional WM masks.

STATISTICAL TESTS

A general linear model was applied for the comparison. A statistical power and a minimum sample size for the significant difference were obtained. Spearman's correlation coefficient was calculated between MWF and clinical measures and between ViSTa-MWF and GRASE-MWF for the global WM mask.

RESULTS

MWFs of ViSTa were significantly lower in the MS patients than those in the HC in all masks (P < 0.001). GRASE-MWI results revealed reduced MWFs only in global WM, genu, and optic radiation. ViSTa-MWI had higher statistical powers than that of GRASE-MWI (power: ViSTa = 99.2 ± 1.6% and GRASE = 75.5 ± 31.0%; sample size: ViSTa = 18 ± 9 and GRASE = 78 ± 75). In early-stage MS, MWFs of ViSTa were significantly lower than those of the HC in all masks except for centrum semiovale; however, MWFs of GRASE MWI were significantly lower only in optic radiation. Disease duration was correlated with both MWIs (ViSTa; r = -0.437 and GRASE; r = -0.445). ViSTa and GRASE MWFs were significantly correlated in the HC (r = 0.664) and MS (r = 0.768).

DATA CONCLUSION

ViSTa-MWI may detect a reduction of MWF in NAWM of MS.

LEVEL OF EVIDENCE

3 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;49:1091-1098.

摘要

背景

在多发性硬化症（MS）中，不仅病变部位，而且正常 MRI 表现的白质（NAWM）也可能发生脱髓鞘。

目的

使用短横向弛豫时间成分髓鞘水成像（ViSTa-MWI）直接显示 NAWM 脱髓鞘，以证明其检测能力，并将结果与常规梯度回波和自旋回波（GRASE）-MWI 进行比较。

研究类型

对照/队列。

人群

25 例 MS 患者和 18 例健康对照者（HC）。

磁场强度/序列：3T/ViSTa 和 GRASE-MWI。

评估

使用 ViSTa 和 GRASE-MWI，比较 MS（所有患者或早期 MS 患者）和 HC 之间 NAWM 或正常 WM 的髓鞘水分数（MWF）。比较是在全局 WM 掩模和五个局部 WM 掩模上进行的。

统计学检验

应用广义线性模型进行比较。获得了用于显著差异的统计功效和最小样本量。计算了全局 WM 掩模中 MWF 与临床指标之间以及 ViSTa-MWF 与 GRASE-MWF 之间的 Spearman 相关系数。

结果

在所有掩模中，MS 患者的 ViSTa MWF 均显著低于 HC（P < 0.001）。GRASE-MWI 结果仅显示全局 WM、内囊和视辐射的 MWF 降低。ViSTa-MWI 的统计功效高于 GRASE-MWI（功效：ViSTa=99.2%±1.6%和 GRASE=75.5%±31.0%；样本量：ViSTa=18±9 和 GRASE=78±75）。在早期 MS 中，除半卵圆中心外，所有掩模中 ViSTa 的 MWF 均显著低于 HC；然而，GRASE MWI 的 MWF 仅在视辐射中显著降低。疾病持续时间与两种 MWI 均相关（ViSTa：r=-0.437，GRASE：r=-0.445）。HC 和 MS 中 ViSTa 和 GRASE MWF 均显著相关（r=0.664 和 r=0.768）。