Department of General Radiology, Interventional Radiology and Neuroradiology, Wroclaw Medical University, Poland.
Adv Clin Exp Med. 2019 Jul;28(7):989-999. doi: 10.17219/acem/94137.
We review the current role of magnetic resonance (MR) volumetry as a meaningful indicator of neurodegeneration and clinical disease progression in multiple sclerosis (MS) patients. Based on a review of the current literature we summarize the mechanisms that contribute to brain atrophy. We present the newest magnetic resonance imaging (MRI)-based methods used in atrophy quantification. We also analyze important biological factors which can influence the accuracy of brain atrophy evaluation. Evidence shows that measures of brain volume (BV) have the potential to be an important determinant of disease progression to a greater extent than conventional lesion assessment. Finally, scientific reports concerning limitations of MRI-based volumetry that affect its implementation into routine clinical practice are also reviewed. The technical challenges that need to be overcome include creating a standardized protocol for image acquisition - a fully automated, accurate and reproducible method that allows comparison in either single-center or multicenter settings. In the near future, quantitative MR research will probably be the basic method used in neurology to monitor the rate of atrophic processes and clinical deterioration in MS patients, and to evaluate the results of treatment.
我们回顾了磁共振（MR）容积测量在多发性硬化症（MS）患者的神经退行性变和临床疾病进展中的重要指标作用。基于对现有文献的回顾，我们总结了导致脑萎缩的机制。我们介绍了用于萎缩定量的最新磁共振成像（MRI）方法。我们还分析了可能影响脑萎缩评估准确性的重要生物学因素。有证据表明，脑容量（BV）的测量值在一定程度上比传统的病变评估更能预测疾病的进展。最后，我们还回顾了与 MRI 容积测量相关的、影响其在常规临床实践中应用的局限性的科学报告。需要克服的技术挑战包括创建图像采集的标准化方案——一种全自动、准确且可重复的方法，允许在单中心或多中心环境中进行比较。在不久的将来，定量磁共振研究可能成为神经病学中用于监测 MS 患者的萎缩过程和临床恶化的基本方法，并评估治疗结果。
