多模态方法评估萎缩性 T2 病变体积作为多发性硬化症疾病进展的 MRI 标志物的有效性。
A multimodal approach to assess the validity of atrophied T2-lesion volume as an MRI marker of disease progression in multiple sclerosis.
机构信息
Buffalo Neuroimaging Analysis Center, Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 14203, USA.
Departments of Medicine, Biomedicine and Clinical Research, Neurologic Clinic and Policlinic, University Hospital Basel, University of Basel, Basel, Switzerland.
出版信息
J Neurol. 2020 Mar;267(3):802-811. doi: 10.1007/s00415-019-09643-z. Epub 2019 Nov 25.
BACKGROUND
Atrophied T2-lesion volume (LV) is a novel MRI marker representing brain-lesion loss due to atrophy, able to predict long-term disability progression and conversion to secondary-progressive multiple sclerosis (MS).
OBJECTIVE
To better characterize atrophied T2-LV via comparison with other multidisciplinary markers of MS progression.
METHODS
We studied 127 MS patients (85 relapsing-remitting, RRMS and 42 progressive, PMS) and 20 clinically isolated syndrome (CIS) utilizing MRI, optical coherence tomography, and serum neurofilament light chain (sNfL) at baseline and at 5-year follow-up. Symbol Digit Modalities Test (SDMT) was obtained at follow-up. Atrophied T2-LV was calculated by combining baseline lesion masks with follow-up CSF partial-volume maps. Measures were compared between MS patients who developed or not disease progression (DP). Partial correlations between atrophied T2-LV and other biomarkers were performed, and corrected for multiple comparisons.
RESULTS
Atrophied T2-LV was the only biomarker that significantly differentiated DP from non-DP patients over the follow-up (p = 0.007). In both DP and non-DP groups, atrophied T2-LV was associated with baseline T2-LV and T1-LV (both p = 0.003), absolute change of T1-LV (DP p = 0.038; non-DP p = 0.003) and percentage of brain volume change (both p = 0.003). Furthermore, in the DP group, atrophied T2-LV was related to baseline brain parenchymal (p = 0.017) and thalamic (p = 0.003) volumes, thalamic volume change and follow-up SDMT (both p = 0.003). In non-DP patients, atrophied T2-LV was significantly related to baseline sNfL (p = 0.008), contrast-enhancing LV (p = 0.02) and percentage ventricular volume change (p = 0.003).
CONCLUSION
Atrophied T2-LV is associated with disability accrual in MS, and to several multimodal markers of disease evolution.
背景
萎缩性 T2 病变体积（LV）是一种新的 MRI 标志物，代表因萎缩导致的脑病变损失，能够预测长期残疾进展和向继发性进展型多发性硬化症（MS）的转化。
目的
通过与 MS 进展的其他多学科标志物进行比较，更好地描述萎缩性 T2-LV。
方法
我们研究了 127 名 MS 患者（85 名复发缓解型 MS，RRMS 和 42 名进展型 MS，PMS）和 20 名临床孤立综合征（CIS）患者，在基线和 5 年随访时利用 MRI、光相干断层扫描和血清神经丝轻链（sNfL）进行评估。在随访时获得符号数字模态测试（SDMT）。通过将基线病变掩模与随访时的 CSF 部分容积图相结合，计算出萎缩性 T2-LV。比较了在随访期间发生或未发生疾病进展（DP）的 MS 患者之间的各项指标。对萎缩性 T2-LV 与其他生物标志物之间进行偏相关分析，并进行了多次比较校正。
结果
在整个随访期间，萎缩性 T2-LV 是唯一能够将 DP 患者与非 DP 患者区分开来的生物标志物（p=0.007）。在 DP 和非 DP 组中，萎缩性 T2-LV 与基线 T2-LV 和 T1-LV 均相关（均 p=0.003），与 T1-LV 的绝对变化也相关（DP p=0.038；非 DP p=0.003）和脑容量变化的百分比（均 p=0.003）。此外，在 DP 组中，萎缩性 T2-LV 与基线脑实质（p=0.017）和丘脑（p=0.003）体积、丘脑体积变化和随访时的 SDMT（均 p=0.003）相关。在非 DP 患者中，萎缩性 T2-LV 与基线 sNfL（p=0.008）、对比增强的 LV（p=0.02）和脑室体积变化的百分比（p=0.003）显著相关。
结论
萎缩性 T2-LV 与 MS 患者的残疾进展相关，并与疾病演变的多个多模态标志物相关。
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