Cocozza Sirio, Pontillo Giuseppe, Lanzillo Roberta, Russo Camilla, Petracca Maria, Di Stasi Martina, Paolella Chiara, Vola Elena Augusta, Criscuolo Chiara, Moccia Marcello, Lamberti Anna, Monti Serena, Brescia Morra Vincenzo, Elefante Andrea, Palma Giuseppe, Tedeschi Enrico, Brunetti Arturo
Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy.
Department of Neurosciences and Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy.
Neuroradiology. 2019 Feb;61(2):155-162. doi: 10.1007/s00234-018-02150-4. Epub 2019 Jan 8.
Different studies showed correlations between gadolinium-based contrast agent (GBCA) administrations and dentate nucleus (DN) T1-weighted hyperintensity. The clinical impact of gadolinium retention, however, is still largely unknown. The aim of this study was to investigate relations between MRI and clinical disability in relapsing-remitting multiple sclerosis (RR-MS) patients.
In this retrospective study, clinical data were obtained from 74 RR-MS patients at baseline and after a mean follow-up time of 3.6 years, including the expanded disability status scale (EDSS) score and its change (ΔEDSS). Patients were considered showing clinical worsening if they score a ΔEDSS ≥ 1 (for baseline EDSS ≤ 5.5) or ΔEDSS ≥ 0.5 (for baseline EDSS > 5.5). From the MRI data, the presence of bilateral DN hyperintensity was recorded along with the calculation of longitudinal relaxation rate (R1) maps.
Patients with DN hyperintensity showed similar ΔEDSS change compared to those without visible changes on T1-weighted images (p = 0.32). Similarly, no DN-R1 difference was found comparing stable patients with those showing a significant clinical worsening (p = 0.54). Finally, no significant effect of DN-R1 values explained the variance in ΔEDSS (p = 0.76), thus suggesting their independence from the clinical outcome.
MS patients with DN hyperintensity show similar EDSS changes compared to subjects without DN high-signal intensity. Furthermore, mean DN-R1 values of patients with significant clinical worsening were comparable to those of stable subjects and were unrelated to clinical disability. Taken together, these findings suggest that gadolinium retention in the brain of MS patients does not affect their clinical worsening, expressed by the EDSS change.
不同研究表明钆基造影剂（GBCA）的使用与齿状核（DN）T1加权高信号之间存在相关性。然而，钆潴留的临床影响仍 largely 未知。本研究的目的是调查复发缓解型多发性硬化症（RR-MS）患者的MRI与临床残疾之间的关系。
在这项回顾性研究中，收集了74例RR-MS患者基线时和平均随访3.6年后的临床数据，包括扩展残疾状态量表（EDSS）评分及其变化（ΔEDSS）。如果患者的ΔEDSS≥1（基线EDSS≤5.5）或ΔEDSS≥0.5（基线EDSS>5.5），则认为其临床病情恶化。从MRI数据中，记录双侧DN高信号的存在情况，并计算纵向弛豫率（R1）图。
与T1加权图像上无可见变化的患者相比，DN高信号患者的ΔEDSS变化相似（p = 0.32）。同样，比较病情稳定的患者与临床病情显著恶化的患者，未发现DN-R1有差异（p = 0.54）。最后，DN-R1值对ΔEDSS的方差无显著影响（p = 0.76），因此表明它们与临床结局无关。
与无DN高信号强度的受试者相比，有DN高信号的MS患者的EDSS变化相似。此外，临床病情显著恶化的患者的平均DN-R1值与病情稳定的受试者相当，且与临床残疾无关。综上所述，这些发现表明MS患者大脑中的钆潴留不会影响其由EDSS变化所表示的临床病情恶化。
