Department of Neurology, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy.
IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
J Neuroimaging. 2024 Sep-Oct;34(5):567-571. doi: 10.1111/jon.13221. Epub 2024 Jul 14.
Pediatric multiple sclerosis (MS) displays different pathological features compared to adult MS, which can be studied in vivo by assessing tissue magnetic susceptibility with 3T-MRI. We aimed to assess different white matter lesions (WMLs) phenotypes in pediatric MS patients using quantitative susceptibility mapping (QSM) and susceptibility mapping weighted imaging (SMWI) over 12 months.
Eleven pediatric MS patients [female: 63.6%; mean ± standard deviation (SD) age and disease duration: 16.3 ± 2.2 and 2.4 ± 1.5; median (range) Expanded Disability Status Scale (EDSS) 1 (0-2)] underwent 3 Tesla-MRI exams and EDSS assessments at baseline and after 1 year. QSM and SMWI were obtained using 3-dimensional (3D)-segmented echo-planar-imaging with submillimetric spatial resolution. WMLs were classified according to their QSM appearance and SMWI was used to identify QSM hyperintensities ascribable to veins. Total brain volumes at baseline and follow-up were computed using high-resolution 3D T1-weighted images.
Mean ± SD paramagnetic rim lesions (PRLs) prevalence was 7.0% ± 9.0. Fifty-four percent (6/11) of patients exhibited at least one PRL, with one patient exhibiting ≥ 4 PRLs. All patients showed QSM-iso-/hypo-intense lesions, which represented a mean ± SD of 65.8% ± 22.7 of total WMLs. QSM-hyperintense WMLs showed a positive correlation with total brain volume reduction at follow-up (r = 0.705; p = .02). No lesion was classified as different between baseline and follow-up.
Chronic compartmentalized inflammation seems to occur early in pediatric MS patients with short disease duration. A high prevalence of iso-/hypo-intense lesions was found, which could account for the higher remyelination potential in pediatric MS.
与成人多发性硬化症（MS）相比，儿科 MS 表现出不同的病理特征，可通过在 3T-MRI 上评估组织磁化率进行体内研究。我们旨在使用定量磁化率图（QSM）和磁化率加权成像（SMWI）在 12 个月内评估儿科 MS 患者的不同白质病变（WML）表型。
11 名儿科 MS 患者[女性：63.6%；平均（±标准差）年龄和疾病持续时间：16.3 ± 2.2 和 2.4 ± 1.5；中位数（范围）扩展残疾状态量表（EDSS）1（0-2）]在基线和 1 年后进行了 3 特斯拉-MRI 检查和 EDSS 评估。使用亚毫米空间分辨率的 3 维（3D）分段回波平面成像获得 QSM 和 SMWI。根据 QSM 外观对 WML 进行分类，并使用 SMWI 识别可归因于静脉的 QSM 高信号。使用高分辨率 3D T1 加权图像计算基线和随访时的总脑容量。
平均（±标准差）顺磁边缘病变（PRL）患病率为 7.0%±9.0。54%（6/11）的患者至少存在一个 PRL，其中一名患者存在≥4 个 PRL。所有患者均显示 QSM 等-/低信号病变，占总 WML 的平均（±标准差）65.8%±22.7。QSM 高信号 WML 与随访时总脑容量减少呈正相关（r = 0.705；p = 0.02）。没有病变在基线和随访之间被分类为不同。
在疾病持续时间较短的儿科 MS 患者中，慢性分隔性炎症似乎很早就发生了。发现高比例的等-/低信号病变，这可能解释了儿科 MS 中更高的髓鞘再生潜力。
