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MRI 在多发性硬化症中的应用的新视角:从病理生理学到临床实践。

Emerging Perspectives on MRI Application in Multiple Sclerosis: Moving from Pathophysiology to Clinical Practice.

机构信息

From the Neuroimaging Research Unit, Division of Neuroscience (M.A.R., M.M., E.P., P.P., L.S., P.V., M.F.), Neurology Unit (M.A.R., M.M., P.P., M.F.), Neurorehabilitation Unit (M.F.), and Neurophysiology Service (M.F.), IRCCS San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy (M.A.R., P.P., M.F.); Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy (M.B.); Queen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK (A.E.); Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK (A.E.); VISN20 NW Mental Illness Research, Education, and Clinical Center, VA Puget Sound Healthcare System, Seattle, Wash (J.I.); Department of Psychiatry and Behavioral Sciences and Department of Neurology, University of Washington School of Medicine, Seattle, Wash (J.I.); and Department of Innovative Biomedical Visualization (iBMV), Department of Radiology, Nagoya University Graduate School of Medicine, Aichi, Japan (T.T.).

出版信息

Radiology. 2023 Jun;307(5):e221512. doi: 10.1148/radiol.221512.

Abstract

MRI plays a central role in the diagnosis of multiple sclerosis (MS) and in the monitoring of disease course and treatment response. Advanced MRI techniques have shed light on MS biology and facilitated the search for neuroimaging markers that may be applicable in clinical practice. MRI has led to improvements in the accuracy of MS diagnosis and a deeper understanding of disease progression. This has also resulted in a plethora of potential MRI markers, the importance and validity of which remain to be proven. Here, five recent emerging perspectives arising from the use of MRI in MS, from pathophysiology to clinical application, will be discussed. These are the feasibility of noninvasive MRI-based approaches to measure glymphatic function and its impairment; T1-weighted to T2-weighted intensity ratio to quantify myelin content; classification of MS phenotypes based on their MRI features rather than on their clinical features; clinical relevance of gray matter atrophy versus white matter atrophy; and time-varying versus static resting-state functional connectivity in evaluating brain functional organization. These topics are critically discussed, which may guide future applications in the field.

摘要

MRI 在多发性硬化症(MS)的诊断以及疾病过程和治疗反应的监测中发挥着核心作用。高级 MRI 技术揭示了 MS 的生物学特性,并促进了寻找可能适用于临床实践的神经影像学标志物的研究。MRI 提高了 MS 诊断的准确性,并加深了对疾病进展的理解。这也导致了大量潜在的 MRI 标志物的出现,这些标志物的重要性和有效性仍有待证实。在这里,将讨论从 MRI 在 MS 中的应用中出现的五个新的研究方向,从病理生理学到临床应用。这些方向包括使用非侵入性 MRI 方法测量糖液功能及其损伤的可行性;T1 加权到 T2 加权强度比来量化髓鞘含量;基于 MRI 特征而不是临床特征对 MS 表型进行分类;灰质萎缩与白质萎缩的临床相关性;以及在评估大脑功能组织时,时变与静息状态功能连接的比较。这些主题都进行了批判性的讨论,这可能为该领域的未来应用提供指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/33f0/10315528/01df32a3d57c/radiol.221512.VA.jpg

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