Department of Radiology, Washington University in St. Louis, St. Louis, MO, USA.
Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA.
Mult Scler. 2022 Sep;28(10):1515-1525. doi: 10.1177/13524585211073761. Epub 2022 Feb 23.
Imaging biomarkers of progressive multiple sclerosis (MS) are needed. Quantitative gradient recalled echo (qGRE) magnetic resonance imaging (MRI) evaluates microstructural tissue damage in MS.
To evaluate qGRE-derived R2t* as an imaging biomarker of MS progression compared with atrophy and lesion burden.
Twenty-three non-relapsing progressive MS (PMS), 22 relapsing-remitting MS (RRMS), and 18 healthy control participants underwent standard MS physical and cognitive neurological assessments and imaging with qGRE, FLAIR, and MPRAGE at 3T. PMS subjects were tested clinically and imaged every 9 months over 45 months. Imaging measures included lesion burden, atrophy, and R2t* in cortical gray matter (GM), deep GM, and normal-appearing white matter (NAWM). Longitudinal analysis of clinical performance and imaging biomarkers in PMS subjects was conducted via linear models with subject as repeated, within-subject factor. Relationship between imaging biomarkers and clinical scores was assessed by Spearman rank correlation.
R2t* reductions correlated with neurological impairment cross-sectionally and longitudinally. PMS patients with clinically defined disease progression ( = 13) showed faster decrease of R2t* in NAWM and deep GM compared with the clinically stable PMS group ( = 10). Importantly, tissue damage measured by R2t* outperformed lesion burden and atrophy as a biomarker of progression during the study period.
qGRE-derived R2t* is a potential imaging biomarker of MS progression.
需要用于多发性硬化症（MS）进展的成像生物标志物。定量梯度回波（qGRE）磁共振成像（MRI）评估 MS 中的微观结构组织损伤。
评估 qGRE 衍生的 R2t*作为 MS 进展的成像生物标志物，与萎缩和病变负荷进行比较。
23 名非复发进展型 MS（PMS）、22 名复发缓解型 MS（RRMS）和 18 名健康对照参与者在 3T 下接受了标准的 MS 物理和认知神经学评估以及 qGRE、FLAIR 和 MPRAGE 成像。PMS 受试者在 45 个月内每 9 个月进行一次临床和影像学检查。成像测量包括皮质灰质（GM）、深部 GM 和正常外观白质（NAWM）中的病变负荷、萎缩和 R2t*。通过线性模型对 PMS 受试者的临床表现和成像生物标志物进行纵向分析，受试者作为重复的、个体内因素。通过 Spearman 秩相关评估成像生物标志物与临床评分之间的关系。
R2t的减少与横断面和纵向神经功能障碍相关。与临床稳定的 PMS 组（n=10）相比，具有临床定义的疾病进展（n=13）的 PMS 患者在 NAWM 和深部 GM 中显示出更快的 R2t降低。重要的是，在研究期间，R2t*测量的组织损伤优于病变负荷和萎缩，是进展的生物标志物。
qGRE 衍生的 R2t*是 MS 进展的潜在成像生物标志物。
