Sedaghat Sam, Jang Hyungseok, Athertya Jiyo S, Groezinger Martin, Corey-Bloom Jody, Du Jiang
Department of Radiology, University of California, San Diego, San Diego, CA, United States.
University Hospital Heidelberg, Heidelberg, Germany.
Front Neurosci. 2023 Mar 13;17:1145251. doi: 10.3389/fnins.2023.1145251. eCollection 2023.
Although many lesion-based MRI biomarkers in multiple sclerosis (MS) patients were investigated, none of the previous studies dealt with the signal intensity variations (SIVs) of MS lesions. In this study, the SIVs of MS lesions on direct myelin imaging and standard clinical sequences as possible MRI biomarkers for disability in MS patients were assessed.
Twenty seven MS patients were included in this prospective study. IR-UTE, FLAIR, and MPRAGE sequences were employed on a 3T scanner. Regions of interest (ROIs) were manually drawn within the MS lesions, and the cerebrospinal fluid (CSF) and signal intensity ratios (SIR) were calculated from the derived values. Variations coefficients were determined from the standard deviations (Coeff 1) and the absolute differences (Coeff 2) of the SIRs. Disability grade was assessed by the expanded disability status scale (EDSS). Cortical/gray matter, subcortical, infratentorial, and spinal lesions were excluded.
The mean diameter of the lesions was 7.8 ± 1.97 mm, while the mean EDSS score was 4.5 ± 1.73. We found moderate correlations between the EDSS and Coeff 1 and 2 on IR-UTE and MPRAGE images. Accordingly, Pearson's correlations on IR-UTE were = 0.51 ( = 0.007) and = 0.49 ( = 0.01) for Coeff 1 and 2, respectively. For MPRAGE, Pearson's correlations were = 0.5 ( = 0.008) and = 0.48 ( = 0.012) for Coeff 1 and 2, respectively. For FLAIR, only poor correlations could be found.
The SIVs of MS lesions on IR-UTE and MPRAGE images, assessed by Coeff 1 and 2, could be used as novel potential MRI biomarkers for patients' disability.
尽管对多发性硬化症（MS）患者中许多基于病灶的MRI生物标志物进行了研究，但以往的研究均未涉及MS病灶的信号强度变化（SIV）。在本研究中，评估了直接髓鞘成像和标准临床序列上MS病灶的SIV，将其作为MS患者残疾程度的潜在MRI生物标志物。
本前瞻性研究纳入了27例MS患者。在3T扫描仪上采用IR-UTE、FLAIR和MPRAGE序列。在MS病灶内手动绘制感兴趣区（ROI），并根据导出值计算脑脊液（CSF）和信号强度比（SIR）。变异系数由SIR的标准差（系数1）和绝对差值（系数2）确定。残疾程度采用扩展残疾状态量表（EDSS）进行评估。排除皮质/灰质、皮质下、幕下和脊髓病灶。
病灶的平均直径为7.8±1.97mm，而平均EDSS评分为4.5±1.73。我们发现EDSS与IR-UTE和MPRAGE图像上的系数1和系数2之间存在中度相关性。因此，IR-UTE上系数1和系数2的Pearson相关性分别为r = 0.51（p = 0.007）和r = 0.49（p = 0.01）。对于MPRAGE，系数1和系数2的Pearson相关性分别为r = 0.5（p = 0.008）和r = 0.48（p = 0.012）。对于FLAIR，仅发现弱相关性。
通过系数1和系数2评估的IR-UTE和MPRAGE图像上MS病灶的SIV，可作为评估患者残疾程度的新型潜在MRI生物标志物。
