钆对比剂在多发性硬化症患者脊髓磁共振成像中的诊断价值及病变强化的相关标志物

Diagnostic value of gadolinium contrast administration for spinal cord magnetic resonance imaging in multiple sclerosis patients and correlative markers of lesion enhancement.

作者信息

Karimian-Jazi Kianush, Neuberger Ulf, Schregel Katharina, Brugnara Gianluca, Schwarz Daniel, Jäger Laura Bettina, Wick Wolfgang, Bendszus Martin, Breckwoldt Michael O

机构信息

Neurology Clinic, University Hospital Heidelberg, Heidelberg, Germany.

Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK) within the German Cancer Research Center (DKFZ), Heidelberg, Germany Neurology Clinic and National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany.

出版信息

Mult Scler J Exp Transl Clin. 2021 Nov 26;7(4):20552173211047978. doi: 10.1177/20552173211047978. eCollection 2021 Oct.

DOI:10.1177/20552173211047978

PMID:34868625

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8637714/

Abstract

BACKGROUND

Magnetic resonance imaging is essential for monitoring people with multiple sclerosis, but the diagnostic value of gadolinium contrast administration in spine magnetic resonance imaging is unclear.

OBJECTIVE

To assess the diagnostic value of gadolinium contrast administration in spine magnetic resonance imaging follow-up examinations and identify imaging markers correlating with lesion enhancement.

METHODS

A total of 65 multiple sclerosis patients with at least 2 spinal magnetic resonance imaging follow-up examinations were included. Spine magnetic resonance imaging was performed at 3 Tesla with a standardized protocol (sagittal and axial T2-weighted turbo spin echo and T1-weighted post-contrast sequences). T2 lesion load and enhancing lesions were assessed by two independent neuroradiologists for lesion size, localization, and T2 signal ratio (T2 signal/T2 signal).

RESULTS

A total of 68 new spinal T2 lesions and 20 new contrast-enhancing lesions developed during follow-up. All enhancing lesions had a discernable correlate as a new T2 lesion. Lesion enhancement correlated with a higher T2 signal ratio compared to non-enhancing lesions (T2 signal ratio: 2.0 ± 0.4 vs. 1.4 ± 0.2, **** < 0.001). Receiver operating characteristics analysis showed an optimal cutoff value of signal ratio 1.78 to predict lesion enhancement (82% sensitivity and 97% specificity).

CONCLUSION

Gadolinium contrast administration is dispensable in follow-up spine magnetic resonance imaging if no new T2 lesions are present. Probability of enhancement correlates with the T2 signal ratio.

摘要

背景

磁共振成像对于监测多发性硬化症患者至关重要，但钆对比剂在脊柱磁共振成像中的诊断价值尚不清楚。

目的

评估钆对比剂在脊柱磁共振成像随访检查中的诊断价值，并确定与病变强化相关的影像学标志物。

方法

纳入65例至少接受过2次脊柱磁共振成像随访检查的多发性硬化症患者。在3特斯拉磁场下采用标准化方案（矢状位和轴位T2加权快速自旋回波序列以及T1加权增强后序列）进行脊柱磁共振成像检查。由两名独立的神经放射科医生评估T2病变负荷和强化病变的大小、位置及T2信号比（T2信号/T2信号）。

结果

随访期间共出现68个新的脊柱T2病变和20个新的强化病变。所有强化病变均与一个新的T2病变有明显关联。与未强化病变相比，强化病变的T2信号比更高（T2信号比：2.0±0.4 vs. 1.4±0.2，****<0.001）。受试者工作特征分析显示，预测病变强化的信号比最佳截断值为1.78（灵敏度82%，特异度97%）。