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脑 MRI 在多发性硬化症患者诊断和随访中的应用进展。

Update on brain MRI for the diagnosis and follow-up of MS patients.

机构信息

Observatoire Français de la Sclérose en Plaques, Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292, 69003 Lyon, France.

Observatoire Français de la Sclérose en Plaques, Centre de Recherche en Neurosciences de Lyon, INSERM 1028 et CNRS UMR 5292, 69003 Lyon, France; Hospices Civils de Lyon, Service de Neurologie, sclérose en plaques, pathologies de la myéline et neuro-inflammation, 69677 Bron, France; Université de Lyon, Université Claude Bernard Lyon 1, 69000 Lyon, France.

出版信息

Presse Med. 2021 Jun;50(2):104067. doi: 10.1016/j.lpm.2021.104067. Epub 2021 May 11.

DOI:10.1016/j.lpm.2021.104067
PMID:33989722
Abstract

Over the past decades, MRI has become a major tool in the diagnosis and the follow-up of patients with multiple sclerosis (MS), especially for monitoring the effectiveness of therapy. The recent international recommendations issued for the standardization of neurological and radiological clinical practices converge on many points. In this setting, recommendations made by the "Observatoire français de la sclérose en plaques", the French MS registry, can be distinguished by its interdisciplinary complementarity, its longevity, its size, and its positions in direct connection with the clinic. Hence, after suspicions of gadolinium deposition in the brain, with multiple warning from the American and European health authorities, a national consultation took place and resulted in limitation to useful injections. The precautionary principle prevailing, the patient receives a limited quantity of contrast product even if no clinically harmful manifestation has been detected to date. The result of this round table bringing together neurologists and neuroradiologists from specialized centers was published in the form of a recommendation in early 2020. The interest of this project also lies in the constant improvement of the management of patients with MS and the possibility of developing advanced techniques to assist the clinician. The aim of this review is to explain to the neurologist, the interest of following this imaging protocol both in his/her clinical practice and in the possibilities that this opens up.

摘要

在过去的几十年中,磁共振成像(MRI)已成为多发性硬化症(MS)患者诊断和随访的主要工具,尤其是用于监测治疗效果。最近为规范神经学和放射学临床实践而发布的国际建议在许多方面达成了共识。在这种情况下,法国多发性硬化症观察站(Observatoire français de la sclérose en plaques),即法国多发性硬化症登记处的建议具有以下特点:跨学科互补性、长期性、规模以及与临床的直接联系。因此,在美国和欧洲卫生当局多次发出钆沉积警告后,对其进行了全国性咨询,并限制了有用的注射。由于预防原则占主导地位,即使迄今为止未发现任何临床上有害的表现,患者仍会接受有限数量的造影剂。这次汇集了来自专门中心的神经科医生和神经放射科医生的圆桌会议的结果以建议的形式于 2020 年初发表。该项目的另一个意义在于不断改善多发性硬化症患者的管理,并有可能开发出辅助临床医生的先进技术。本文旨在向神经科医生解释遵循该成像方案在其临床实践和可能带来的益处。

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引用本文的文献

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Looking at the rim in multiple sclerosis: new MRI-based biomarkers may open our eyes to the disease's evolution.观察多发性硬化症的边缘:基于磁共振成像的新生物标志物可能会让我们对该疾病的发展有新的认识。
Eur Radiol. 2024 Feb;34(2):1334-1336. doi: 10.1007/s00330-023-10482-w. Epub 2023 Dec 20.
2
COVID-19 and its implications on the clinico-radiological course of multiple sclerosis: A case-control study.新型冠状病毒肺炎及其对多发性硬化症临床放射学病程的影响:一项病例对照研究。
Med Clin (Engl Ed). 2023 Mar 10;160(5):187-192. doi: 10.1016/j.medcle.2022.06.021. Epub 2023 Mar 3.
3
COVID-19 and its implications on the clinico-radiological course of multiple sclerosis: A case-control study.
新型冠状病毒肺炎及其对多发性硬化临床-放射学病程的影响:一项病例对照研究。
Med Clin (Barc). 2023 Mar 10;160(5):187-192. doi: 10.1016/j.medcli.2022.06.020. Epub 2022 Aug 10.