Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
J Magn Reson Imaging. 2024 Jul;60(1):291-301. doi: 10.1002/jmri.29027. Epub 2023 Sep 28.
Recent evidence highlights the potential of axonal degeneration as a biomarker for amyotrophic lateral sclerosis (ALS) detection. However, the diagnostic potential of peripheral nerve axon changes in ALS remains unclear.
To evaluate the diagnostic performance of quantitative MRI of the brachial plexus and limb-girdle muscles (LGMs) in patients with upper extremity onset of ALS.
Retrospective.
47 patients with upper extremity onset of ALS and 20 healthy volunteers.
FIELD STRENGTH/SEQUENCE: 3-T, three-dimensional sampling perfection with application-optimized contrasts using different flip angle evolutions with short-tau inversion recovery sequences, T2-weighted turbo spin-echo Dixon sequence.
The cross-sectional area (CSA) and nerve-muscle T2 signal intensity ratio (nT2) of the bilateral brachial plexus as well as the CSA and fat fraction (FF) of the bilateral LGMs were assessed by two radiologists. Disease severity and clinical stage of ALS patients were assessed by two neurologists.
Student's t-test, Wilcoxon rank-sum test, binary logistic regression, interclass correlation coefficient, receiver operating characteristic analysis, and correlation analysis were performed for MRI quantitative metrics and clinical variables. Significance level: P < 0.05.
In the affected limbs of patients with ALS, the CSA of the brachial plexus roots, trunks, and cords and the nT2 values of the brachial plexus trunks were significantly smaller than in the healthy controls. In the LGMs, the affected limbs of ALS showed significantly smaller CSA and higher FF than controls. The model containing parameters such as brachial plexus trunk CSA, subscapularis CSA, infraspinatus CSA, and subscapularis FF had excellent diagnostic efficacy for ALS. Additionally, increased subscapularis FF and supraspinatus FF were correlated with disease severity, and subscapularis CSA was negatively correlated with the clinical stage.
Brachial plexus thinning, LGM atrophy, and fatty infiltration might serve as MRI-derived biomarkers for ALS with upper extremity onset.
4 TECHNICAL EFFICACY: Stage 2.
最近的证据强调了轴突变性作为肌萎缩侧索硬化症（ALS）检测生物标志物的潜力。然而，ALS 中周围神经轴突变化的诊断潜力尚不清楚。
评估上肢起病 ALS 患者的臂丛和肢体带肌（LGM）定量 MRI 的诊断性能。
回顾性。
47 例上肢起病 ALS 患者和 20 名健康志愿者。
磁场强度/序列：3T，三维采样完美，应用优化对比度，采用不同翻转角演化和短τ反转恢复序列、T2 加权涡轮自旋回波 Dixon 序列。
两位放射科医生评估双侧臂丛的横截面积（CSA）和神经-肌肉 T2 信号强度比（nT2），以及双侧 LGM 的 CSA 和脂肪分数（FF）。两位神经科医生评估 ALS 患者的疾病严重程度和临床分期。
对 MRI 定量指标和临床变量进行学生 t 检验、Wilcoxon 秩和检验、二项逻辑回归、组内相关系数、受试者工作特征分析和相关分析。显著性水平：P<0.05。
在 ALS 患者的患侧肢体中，臂丛神经根、干和索的 CSA 和臂丛干的 nT2 值明显小于健康对照组。在 LGM 中，ALS 患侧肢体的 CSA 明显小于对照组，FF 明显更高。包含臂丛干 CSA、肩胛下肌 CSA、冈下肌 CSA 和肩胛下肌 FF 等参数的模型对 ALS 具有出色的诊断效能。此外，肩胛下肌 FF 和冈上肌 FF 的增加与疾病严重程度相关，而肩胛下肌 CSA 与临床分期呈负相关。
臂丛变薄、LGM 萎缩和脂肪浸润可能成为上肢起病 ALS 的 MRI 衍生生物标志物。
4 级
2 级
