Subramanian Karthikeyan, Utriainen David, Ramasamy Deepa P, Sethi Sean K, Schweser Ferdinand, Beaver John, Hagemeier Jesper, Weinstock-Guttman Bianca, Rajagovindan Rajasimhan, Zivadinov Robert, Haacke Ewart Mark
Department of Radiology, Wayne State University, Detroit, MI 48201, USA.
Magnetic Resonance Innovations, Inc., Bingham Farms, MI 48025, USA.
Diagnostics (Basel). 2020 Nov 12;10(11):942. doi: 10.3390/diagnostics10110942.
We hypothesized that cerebral microbleeds (CMBs) in multiple sclerosis (MS) patients will be detected with higher prevalence compared to healthy controls (HC) and that quantitative susceptibility mapping (QSM) will help remove false positives seen in susceptibility weighted imaging (SWI). A cohort of 100 relapsing remitting MS subjects scanned at 3T were used to validate a set of CMB detection guidelines specifically using QSM. A second longitudinal cohort of 112 MS and 25 HCs, also acquired at 3T, was reviewed across two time points. Both cohorts were imaged with SWI and fluid attenuated inversion recovery. Fourteen subjects in the first cohort (14%, 95% CI 8-21%) and twenty-one subjects in the second cohort (18.7%, 95% CI 11-27%) had at least one CMB. The combined information from SWI and QSM allowed us to discern stable CMBs and new CMBs from potential mimics and evaluate changes over time. The longitudinal results demonstrated that longer disease duration increased the chance to develop new CMBs. Higher age was also associated with increased CMB prevalence for MS and HC. We observed that MS subjects developed new CMBs between time points, indicating the need for longitudinal quantitative imaging of CMBs.
我们假设，与健康对照（HC）相比，多发性硬化症（MS）患者脑微出血（CMB）的检出率更高，并且定量磁化率成像（QSM）将有助于消除磁敏感加权成像（SWI）中出现的假阳性。使用一组在3T场强下扫描的100例复发缓解型MS受试者来验证一套专门使用QSM的CMB检测指南。对另一组同样在3T场强下采集的112例MS患者和25例HC进行纵向研究，在两个时间点进行复查。两组均进行了SWI和液体衰减反转恢复序列成像。第一组中有14名受试者（14%，95%置信区间8 - 21%），第二组中有21名受试者（18.7%，95%置信区间11 - 27%）至少有一处CMB。来自SWI和QSM的综合信息使我们能够从潜在的类似物中辨别出稳定的CMB和新出现的CMB，并评估随时间的变化。纵向研究结果表明，病程越长，出现新CMB的机会越大。年龄越大，MS患者和HC中CMB的患病率也越高。我们观察到MS患者在两个时间点之间出现了新的CMB，这表明需要对CMB进行纵向定量成像。
