From the Department of Radiology (H.J., Y.-J.M., E.Y.C., S.F., R.R.L., A.F.L., G.M.B., J.D.), University of California San Diego, San Diego, California.
Radiology Service (E.Y.C., R.R.L.), VA San Diego Healthcare System, San Diego, California.
AJNR Am J Neuroradiol. 2021 May;42(5):868-874. doi: 10.3174/ajnr.A7006. Epub 2021 Feb 18.
MR imaging has been widely used for the noninvasive evaluation of MS. Although clinical MR imaging sequences are highly effective in showing focal macroscopic tissue abnormalities in the brains of patients with MS, they are not specific to myelin and correlate poorly with disability. We investigated direct imaging of myelin using a 2D adiabatic inversion recovery ultrashort TE sequence to determine its value in assessing disability in MS.
The 2D inversion recovery ultrashort TE sequence was evaluated in 14 healthy volunteers and 31 patients with MS. MPRAGE and T2-FLAIR images were acquired for comparison. Advanced Normalization Tools were used to correlate inversion recovery ultrashort TE, MPRAGE, and T2-FLAIR images with disability assessed by the Expanded Disability Status Scale.
Weak correlations were observed between normal-appearing white matter volume ( = -0.03, = .88), lesion load ( = 0.22, = .24), and age ( = 0.14, = .44), and disability. The MPRAGE signal in normal-appearing white matter showed a weak correlation with age ( = -0.10, = .49) and disability ( = -0.19, = .31). The T2-FLAIR signal in normal-appearing white matter showed a weak correlation with age ( = 0.01, = .93) and disability ( = 0.13, = .49). The inversion recovery ultrashort TE signal was significantly negatively correlated with age ( = -0.38, = .009) and disability ( = -0.44; = .01).
Direct imaging of myelin correlates with disability in patients with MS better than indirect imaging of long-T2 water in WM using conventional clinical sequences.
磁共振成像（MRI）已广泛用于多发性硬化症（MS）的无创评估。尽管临床 MRI 序列在显示 MS 患者大脑中的局灶性宏观组织异常方面非常有效，但它们对髓鞘没有特异性，与残疾相关性差。我们使用二维（2D）绝热反转恢复超短回波时间（TE）序列直接成像髓鞘，以确定其在评估 MS 残疾中的价值。
在 14 名健康志愿者和 31 名 MS 患者中评估了 2D 反转恢复超短 TE 序列。获取磁共振质子密度加权成像（MPRAGE）和 T2 液体衰减反转恢复（FLAIR）图像进行比较。使用高级归一化工具将反转恢复超短 TE、MPRAGE 和 T2-FLAIR 图像与扩展残疾状况量表（EDSS）评估的残疾相关联。
正常表现白质体积（ = -0.03， =.88）、病变负荷（ = 0.22， =.24）和年龄（ = 0.14， =.44）与残疾之间观察到弱相关性。正常表现白质的 MPRAGE 信号与年龄（ = -0.10， =.49）和残疾（ = -0.19， =.31）呈弱相关性。正常表现白质的 T2-FLAIR 信号与年龄（ = 0.01， =.93）和残疾（ = 0.13， =.49）呈弱相关性。反转恢复超短 TE 信号与年龄（ = -0.38， =.009）和残疾（ = -0.44； =.01）呈显著负相关。
与使用常规临床序列间接成像 WM 中的长 T2 水相比，直接成像髓鞘与 MS 患者的残疾相关性更好。
