Yasui Masaaki, Koh Jinsoo, Nakayama Yoshiaki, Sakata Mayumi, Hiwatani Yasuhiro, Ishiguchi Hiroshi, Ito Hidefumi
Department of Neurology, Wakayama Medical University, 811-1, Kimiidera, Wakayama-shi, Wakayama, Japan.
Department of Neurology, Wakayama Medical University, 811-1, Kimiidera, Wakayama-shi, Wakayama, Japan.
J Neurol Sci. 2023 Jan 15;444:120524. doi: 10.1016/j.jns.2022.120524. Epub 2022 Dec 12.
Susceptibility-weighted imaging (SWI) was developed as a diagnostic tool for amyotrophic lateral sclerosis (ALS). However, its sensitivity and specificity are insufficient for accurate diagnosis. Herein, we investigated a new, simple evaluation method for SWI as a diagnostic marker for ALS. We retrospectively investigated 36 patients with ALS and 19 healthy controls. The low signal intensity was semi-quantitatively evaluated on SWI using the motor cortex low intensity (MCLI) score: the sum score of the visual evaluation for the signal intensity of the bilateral primary motor cortices (orofacial, upper-limb, and lower-limb regions) from 0 (isointense) to 2 (markedly hypointense) with a total of 12 points. The mean MCLI score of two independent raters was significantly higher in ALS (median [interquartile range]; 5 [4-6]) than in controls (0 [0-1]), p < 0.0001. When the cutoff value of the MCLI score was set to 3, the area under the receiver operating characteristic curve was 0.973, and the sensitivity and specificity were 0.92 and 1.00, respectively. The MCLI score was not significantly correlated with age, disease duration, and ALS functional rating scale-revised (FRS-R), but was significantly correlated with the progression rate (∆FRS) (ρ = 0.39, p = 0.021) and upper motor neuron score (ρ = 0.51, p = 0.0014). Therefore, MCLI scoring is a useful diagnostic marker for ALS as the MCLI score was correlated with the UMN and ∆FRS scores.
磁敏感加权成像（SWI）被开发用作肌萎缩侧索硬化症（ALS）的诊断工具。然而，其敏感性和特异性不足以进行准确诊断。在此，我们研究了一种新的、简单的SWI评估方法，作为ALS的诊断标志物。我们回顾性研究了36例ALS患者和19名健康对照者。使用运动皮质低信号强度（MCLI）评分对SWI上的低信号强度进行半定量评估：对双侧初级运动皮质（口面部、上肢和下肢区域）信号强度的视觉评估总分，从0（等信号）到2（明显低信号），共12分。两名独立评估者的平均MCLI评分在ALS患者中（中位数[四分位间距]；5[4 - 6]）显著高于对照组（0[0 - 1]），p < 0.0001。当MCLI评分的临界值设定为3时，受试者工作特征曲线下面积为0.973，敏感性和特异性分别为0.92和1.00。MCLI评分与年龄、病程和修订的ALS功能评定量表（FRS - R）无显著相关性，但与进展率（∆FRS）（ρ = 0.39，p = 0.021）和上运动神经元评分（ρ = 0.51，p = 0.0014）显著相关。因此，MCLI评分是ALS的一种有用诊断标志物，因为MCLI评分与UMN和∆FRS评分相关。
