7.0 特斯拉下多发性硬化症的磁共振成像。

Magnetic Resonance Imaging of Multiple Sclerosis at 7.0 Tesla.

机构信息

Berlin Ultrahigh Field Facility (B.U.F.F.), Max Delbrück Center for Molecular Medicine in the Helmholtz Association.

Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health.

出版信息

J Vis Exp. 2021 Feb 19(168). doi: 10.3791/62142.

DOI:10.3791/62142

PMID:33682856

Abstract

The overall goal of this article is to demonstrate a state-of-the-art ultrahigh field (UHF) magnetic resonance (MR) protocol of the brain at 7.0 Tesla in multiple sclerosis (MS) patients. MS is a chronic inflammatory, demyelinating, neurodegenerative disease that is characterized by white and gray matter lesions. Detection of spatially and temporally disseminated T2-hyperintense lesions by the use of MRI at 1.5 T and 3 T represents a crucial diagnostic tool in clinical practice to establish accurate diagnosis of MS based on the current version of the 2017 McDonald criteria. However, the differentiation of MS lesions from brain white matter lesions of other origins can sometimes be challenging due to their resembling morphology at lower magnetic field strengths (typically 3 T). Ultrahigh field MR (UHF-MR) benefits from increased signal-to-noise ratio and enhanced spatial resolution, both key to superior imaging for more accurate and definitive diagnoses of subtle lesions. Hence, MRI at 7.0 T has shown encouraging results to overcome the challenges of MS differential diagnosis by providing MS-specific neuroimaging markers (e.g., central vein sign, hypointense rim structures and differentiation of MS grey matter lesions). These markers and others can be identified by other MR contrasts other than T1 and T2 (T2*, phase, diffusion) and substantially improve the differentiation of MS lesions from those occurring in other neuroinflammatory conditions such as neuromyelitis optica and Susac syndrome. In this article, we describe our current technical approach to study cerebral white and grey matter lesions in MS patients at 7.0 T using different MR acquisition methods. The up-to-date protocol includes the preparation of the MR setup including the radio-frequency coils customized for UHF-MR, standardized screening, safety and interview procedures with MS patients, patient positioning in the MR scanner and acquisition of dedicated brain scans tailored for examining MS.

摘要

本文的总体目标是展示在多发性硬化症（MS）患者中，7.0 特斯拉超高场（UHF）磁共振（MR）脑成像的最新技术。MS 是一种慢性炎症性、脱髓鞘性、神经退行性疾病，其特征是白质和灰质病变。在 1.5T 和 3T 磁共振成像中，通过使用 T2 高信号病变的检测，是在临床实践中建立基于当前 2017 年 McDonald 标准的 MS 准确诊断的重要诊断工具。然而，由于在较低磁场强度（通常为 3T）下病变形态相似，因此区分 MS 病变与其他来源的脑白质病变有时具有挑战性。超高场磁共振（UHF-MR）具有更高的信噪比和更高的空间分辨率优势，这是对更细微病变进行更准确和明确诊断的关键成像优势。因此，7.0T MRI 已显示出令人鼓舞的结果，可以通过提供 MS 特异性神经影像学标志物（例如中央静脉征、低信号边缘结构和 MS 灰质病变的区分）来克服 MS 鉴别诊断的挑战。这些标志物和其他标志物可以通过 T1 和 T2 以外的其他磁共振对比（T2*、相位、扩散）来识别，并大大提高了 MS 病变与其他神经炎症性疾病（如视神经脊髓炎和 Susac 综合征）病变的区分。在本文中，我们描述了我们在 7.0T 时使用不同的磁共振采集方法研究 MS 患者脑白质和灰质病变的当前技术方法。最新的方案包括磁共振设置的准备，包括为 UHF-MR 定制的射频线圈、对 MS 患者的标准化筛查、安全性和访谈程序、患者在磁共振扫描仪中的定位以及专门用于检查 MS 的脑部扫描的采集。