顺磁边缘病变导致多发性硬化症斑块周围白质弥漫性损伤明显。
Paramagnetic rim lesions lead to pronounced diffuse periplaque white matter damage in multiple sclerosis.
机构信息
Department of Neurology, Medical University of Vienna, Vienna, Austria/Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria/Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria/Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.
出版信息
Mult Scler. 2023 Oct;29(11-12):1406-1417. doi: 10.1177/13524585231197954. Epub 2023 Sep 15.
BACKGROUND
Paramagnetic rim lesions (PRLs) are an imaging biomarker in multiple sclerosis (MS), associated with a more severe disease.
OBJECTIVES
To determine quantitative magnetic resonance imaging (MRI) metrics of PRLs, lesions with diffuse susceptibility-weighted imaging (SWI)-hypointense signal (DSHLs) and SWI-isointense lesions (SILs), their surrounding periplaque area (PPA) and the normal-appearing white matter (NAWM).
METHODS
In a cross-sectional study, quantitative MRI metrics were measured in people with multiple sclerosis (pwMS) using the multi-dynamic multi-echo (MDME) sequence post-processing software "SyMRI."
RESULTS
In 30 pwMS, 59 PRLs, 74 DSHLs, and 107 SILs were identified. Beside longer T1 relaxation times of PRLs compared to DSHLs and SILs (2030.5 (1519-2540) vs 1615.8 (1403.3-1953.5) vs 1199.5 (1089.6-1334.6), both < 0.001), longer T1 relaxation times were observed in the PRL PPA compared to the SIL PPA and the NAWM but not the DSHL PPA. Patients with secondary progressive multiple sclerosis (SPMS) had longer T1 relaxation times in PRLs compared to patients with late relapsing multiple sclerosis (lRMS) (2394.5 (2030.5-3040) vs 1869.3 (1491.4-2451.3), = 0.015) and also in the PRL PPA compared to patients with early relapsing multiple sclerosis (eRMS) (982 (927-1093.5) vs 904.3 (793.3-958.5), = 0.013).
CONCLUSION
PRLs are more destructive than SILs, leading to diffuse periplaque white matter (WM) damage. The quantitative MRI-based evaluation of the PRL PPA could be a marker for silent progression in pwMS.
背景
顺磁性边缘病灶（PRL）是多发性硬化症（MS）的一种影像学生物标志物，与更严重的疾病有关。
目的
确定 PRL、弥散性磁敏感加权成像（SWI）低信号病灶（DSHLs）和 SWI 等信号病灶（SILs）、其周围斑块旁区（PPA）和正常表现的白质（NAWM）的定量磁共振成像（MRI）指标。
方法
在一项横断面研究中，使用多动态多回波（MDME）序列后处理软件“SyMRI”对多发性硬化症患者（pwMS）进行定量 MRI 指标测量。
结果
在 30 名 pwMS 中，共发现 59 个 PRL、74 个 DSHLs 和 107 个 SILs。与 DSHLs 和 SILs 相比，PRLs 的 T1 弛豫时间更长（2030.5（1519-2540）与 1615.8（1403.3-1953.5）与 1199.5（1089.6-1334.6），均<0.001），PRL 的 PPA 与 SIL 的 PPA 和 NAWM 相比，T1 弛豫时间更长，但与 DSHL 的 PPA 相比则不然。继发性进展型多发性硬化症（SPMS）患者的 PRL 中 T1 弛豫时间较晚复发型多发性硬化症（lRMS）患者长（2394.5（2030.5-3040）与 1869.3（1491.4-2451.3），=0.015），与早期复发型多发性硬化症（eRMS）患者相比，PRL 的 PPA 中 T1 弛豫时间也更长（982（927-1093.5）与 904.3（793.3-958.5），=0.013）。
结论
PRL 比 SIL 更具破坏性，导致弥漫性斑块旁 WM 损伤。基于 PRL PPA 的定量 MRI 评估可能是 pwMS 中沉默进展的标志物。
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