干扰素-β治疗的多发性硬化症患者中，脱髓鞘斑块数量和体积对治疗反应的预测价值。

Predictive value of number and volume of demyelinating plaques in treatment response in patients with multiple sclerosis treated with INF-B.

作者信息

Azizian Maryam, Ghasemi Darestani Nadia, Aliabadi Athena, Afzali Mahdieh, Tavoosi Nooshin, Fosouli Mahnaz, Khataei Jalil, Aali Halimeh, Nourian Sayed Mohammad Amin

机构信息

School of Medicine, Kerman University of Medical Sciences Kerman, Iran.

School of Medicine, Isfahan University of Medical Sciences Isfahan, Iran.

出版信息

Am J Neurodegener Dis. 2022 Apr 15;11(1):10-16. eCollection 2022.

PMID:35600511

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9123433/

Abstract

BACKGROUND

Multiple Sclerosis (MS) is an autoimmune, inflammatory disease of the central nervous system. Magnetic resonance imaging (MRI) findings are associated with disease clinical activity and response to treatment. This study aimed to evaluate the future value of plaque number and volume in MRI as radiological criteria in determining the treatment response to INF-B in patients with MS.

METHODS

This is a cross-sectional study performed in 2016-2021 in Iran on patients with the newly diagnosed (less than one year) relapsing-remitting MS. Brain MRI was taken for all patients. The number and volumes of the MS plaques were evaluated from FLAIR images by the two radiologists. Patients were treated with INF-B1a with a dosage of 12 million units equal to 44 micrograms subcutaneously, three times per week. Patients were visited monthly by neurologists to examine their clinical status. After one year, the brain MRI was conducted with the similar characteristics to the beginning of the study, and the number and volume of MS plaques were measured again.

RESULTS

The study population consisted of 33 males and 90 females with a mean age of 28.37 ± 6.29 years. The mean Expanded Disability Status Scale (EDSS) of the patients was 3.16 ± 0.23 at the beginning of the study. The specificity for a 50% reduction in the number and volume of plaques as two separate criteria was the same and equal to 100%. The sensitivity of the number and volume of plaques were 65.5% and 90.6%, respectively. In addition, considering 10% as the cut-off point of the number of plaques, the sensitivity of the number of plaques as a criterion was equal to the sensitivity of the plaque volume.

CONCLUSION

The results of this study showed that imaging criteria provide a more objective tool for evaluating the effectiveness of treatment. These findings indicate that the number and volume of plaques could be two reliable MRI imaging criteria for assessing therapy response. The number of plaques was less accurate than the volume of plaques.

摘要

背景

多发性硬化症（MS）是一种中枢神经系统的自身免疫性炎症性疾病。磁共振成像（MRI）结果与疾病的临床活动及治疗反应相关。本研究旨在评估MRI中斑块数量和体积作为放射学标准在确定MS患者对INF-β治疗反应方面的未来价值。

方法

这是一项于2016年至2021年在伊朗对新诊断（不到一年）复发缓解型MS患者进行的横断面研究。对所有患者进行脑部MRI检查。两位放射科医生从液体衰减反转恢复（FLAIR）图像评估MS斑块的数量和体积。患者接受皮下注射剂量为1200万单位（相当于44微克）的INF-β1a治疗，每周三次。神经科医生每月对患者进行访视以检查其临床状态。一年后，进行与研究开始时特征相似的脑部MRI检查，并再次测量MS斑块的数量和体积。

结果

研究人群包括33名男性和90名女性，平均年龄为28.37±6.29岁。研究开始时患者的平均扩展残疾状态量表（EDSS）为3.16±0.23。作为两个独立标准，斑块数量和体积减少50%的特异性相同，均为100%。斑块数量和体积的敏感性分别为65.5%和90.6%。此外，将10%作为斑块数量的截断点时，斑块数量作为标准的敏感性与斑块体积的敏感性相等。