Cooper Graham, Finke Carsten, Chien Claudia, Brandt Alexander U, Asseyer Susanna, Ruprecht Klemens, Bellmann-Strobl Judith, Paul Friedemann, Scheel Michael
NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
Einstein Center for Neurosciences, Berlin, Germany.
Front Neurol. 2019 Apr 9;10:334. doi: 10.3389/fneur.2019.00334. eCollection 2019.
Normal appearing white matter (NAWM) damage develops early in multiple sclerosis (MS) and continues in the absence of new lesions. The ratio of T1w and T2w (T1w/T2w ratio), a measure of white matter integrity, has previously shown reduced intensity values in MS NAWM. We evaluate the validity of a standardized T1w/T2w ratio (sT1w/T2w ratio) in MS and whether this method is sensitive in detecting MS-related differences in NAWM. T1w and T2w scans were acquired at 3 Tesla in 47 patients with relapsing-remitting MS and 47 matched controls (HC). T1w/T2w and sT1w/T2w ratios were then calculated. We compared between-group variability between T1w/T2w and sT1w/T2w ratio in HC and MS and assessed for group differences. We also evaluated the relationship between the T1w/T2w and sT1w/T2w ratios and clinically relevant variables. Compared to the classic T1w/T2w ratio, the between-subject variability in sT1w/T2w ratio showed a significant reduction in MS patients ( < 0.001) and HC ( < 0.001). However, only sT1w/T2w ratio values were reduced in patients compared to HC ( < 0.001). The sT1w/T2w ratio intensity values were significantly influenced by age, T2 lesion volume and group status (MS vs. HC) (adjusted R = 0.30, < 0.001). We demonstrate the validity of the sT1w/T2w ratio in MS and that it is more sensitive to MS-related differences in NAWM compared to T1w/T2w ratio. The sT1w/T2w ratio shows promise as an easily-implemented measure of NAWM in MS using readily available scans and simple post-processing methods.
正常外观的白质（NAWM）损伤在多发性硬化症（MS）早期就会出现，并且在没有新病灶的情况下持续存在。T1加权和T2加权（T1w/T2w）比值是衡量白质完整性的指标，此前已显示MS患者的NAWM中该比值的强度值降低。我们评估了标准化T1w/T2w比值（sT1w/T2w比值）在MS中的有效性，以及该方法在检测NAWM中与MS相关差异时是否敏感。在3特斯拉磁场下，对47例复发缓解型MS患者和47例匹配的对照（HC）进行了T1加权和T2加权扫描。然后计算T1w/T2w和sT1w/T2w比值。我们比较了HC和MS组中T1w/T2w和sT1w/T2w比值的组间变异性，并评估了组间差异。我们还评估了T1w/T2w和sT1w/T2w比值与临床相关变量之间的关系。与经典的T1w/T2w比值相比，sT1w/T2w比值在MS患者（<0.001）和HC（<0.001）中的个体间变异性显著降低。然而，与HC相比，只有患者的sT1w/T2w比值降低（<0.001）。sT1w/T2w比值强度值受年龄、T2病灶体积和组状态（MS与HC）的显著影响（调整后R=0.30，<0.001）。我们证明了sT1w/T2w比值在MS中的有效性，并且与T1w/T2w比值相比，它对NAWM中与MS相关的差异更敏感。sT1w/T2w比值有望成为一种使用现成扫描和简单后处理方法的、易于实施的MS中NAWM测量方法。
