比较 MRI 指标以量化多发性硬化症中的白质微观结构损伤。

Comparing MRI metrics to quantify white matter microstructural damage in multiple sclerosis.

机构信息

Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK.

Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff, UK.

出版信息

Hum Brain Mapp. 2019 Jul;40(10):2917-2932. doi: 10.1002/hbm.24568. Epub 2019 Mar 19.

Abstract

Quantifying white matter damage in vivo is becoming increasingly important for investigating the effects of neuroprotective and repair strategies in multiple sclerosis (MS). While various approaches are available, the relationship between MRI-based metrics of white matter microstructure in the disease, that is, to what extent the metrics provide complementary versus redundant information, remains largely unexplored. We obtained four microstructural metrics from 123 MS patients: fractional anisotropy (FA), radial diffusivity (RD), myelin water fraction (MWF), and magnetisation transfer ratio (MTR). Coregistration of maps of these four indices allowed quantification of microstructural damage through voxel-wise damage scores relative to healthy tissue, as assessed in a group of 27 controls. We considered three white matter tissue-states, which were expected to vary in microstructural damage: normal appearing white matter (NAWM), T2-weighted hyperintense lesional tissue without T1-weighted hypointensity (T2L), and T1-weighted hypointense lesional tissue with corresponding T2-weighted hyperintensity (T1L). All MRI indices suggested significant damage in all three tissue-states, the greatest damage being in T1L. The correlations between indices ranged from r = 0.18 to r = 0.87. MWF was most sensitive when differentiating T2L from NAWM, while MTR was most sensitive when differentiating T1L from NAWM and from T2L. Combining the four metrics into one, through a principal component analysis, did not yield a measure more sensitive to damage than any single measure. Our findings suggest that the metrics are (at least partially) correlated with each other, but sensitive to the different aspects of pathology. Leveraging these differences could be beneficial in clinical trials testing the effects of therapeutic interventions.

摘要

量化多发性硬化症(MS)患者的脑白质损伤正变得越来越重要,因为这有助于研究神经保护和修复策略的效果。虽然有多种方法可供使用,但这些方法在疾病中的脑白质微观结构的 MRI 指标之间的关系(即这些指标在多大程度上提供互补或冗余信息)在很大程度上仍未得到探索。我们从 123 名 MS 患者中获得了 4 个微观结构指标:各向异性分数(FA)、径向扩散系数(RD)、髓鞘水分数(MWF)和磁化传递比(MTR)。通过将这四个指数的图谱配准,我们可以通过相对于健康组织的体素损伤评分来量化微观结构损伤,这是在一组 27 名对照者中评估的。我们考虑了三种白质组织状态,这些状态预计会在微观结构损伤方面有所不同:正常表现的白质(NAWM)、没有 T1 加权低信号的 T2 加权高信号病变组织(T2L)和具有相应 T2 加权高信号的 T1 加权低信号病变组织(T1L)。所有 MRI 指数均表明所有三种组织状态都存在明显的损伤,其中损伤最大的是 T1L。指数之间的相关性范围从 r=0.18 到 r=0.87。MWF 在区分 T2L 和 NAWM 时最敏感,而 MTR 在区分 T1L 和 NAWM 以及区分 T1L 和 T2L 时最敏感。通过主成分分析将这四个指标组合成一个,并不会产生比任何单个指标更敏感的指标。我们的研究结果表明,这些指标彼此之间(至少部分)相关,但对病理学的不同方面敏感。利用这些差异可能有助于临床试验中测试治疗干预效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ceb1/6865710/c193b9c2a439/HBM-40-2917-g001.jpg

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