Toubasi Ahmad A, Lakhani Dhairya A, Cutter Gary, Gheen Caroline, Vinarsky Taegan, Brian Eric, Derwenskus Joy, Eaton James E, Dortch Richard D, Xu Junzhong, Bagnato Francesca
Neuroimaging Unit, Neuroimmunology Division, Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Department of Neuroradiology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, West Virginia, USA.
J Magn Reson Imaging. 2025 Jun;61(6):2444-2454. doi: 10.1002/jmri.29666. Epub 2024 Dec 10.
Selective inversion recovery quantitative magnetization transfer (SIR-qMT)-derived macromolecular to free water pool size ratio (PSR) and diffusion tensor imaging (DTI)-derived radial diffusivity (RD) are potential metrics for assessing myelin integrity in multiple sclerosis (MS). However, establishing their accuracy in identifying tissue injury is essential for clinical translation.
To compare the accuracy and Cohen's effect size (ES) of PSR and RD in detecting and quantifying tissue injury in early MS.
Cross-sectional prospective study.
Fourty-three subjects with newly diagnosed MS (mean age 38 ± 11 years, 70% females) and 18 age- and sex-matched healthy controls (HCs; age 38 ± 12 years, 62.5% females).
FIELD STRENGTH/SEQUENCE: 3-T MRI using T-weighted (T-w) turbo spin echo, T-w fluid-attenuated inversion recovery (FLAIR), DTI, and SIR-qMT sequences.
T-lesions were identified as hyperintense on T-w-FLAIR, and chronic black holes (cBHs) by simultaneous T-w-FLAIR hyperintensity and T-w hypointensity. Regions of interest (ROIs) in normal-appearing white matter (NAWM) were classified as proximal (p) or distant (d) to lesions, while normal white matter (NWM) was identified in HCs. PSR and RD values of T-lesions and cBHs were compared to their matched p/dNAWM and NWM in HCs. Comparisons were also made between T-lesions and cBHs.
Receiver operating characteristic curves evaluated metric accuracy, and paired t tests compared ES values of PSR and RD, with significance set at P < 0.050.
We identified 823 T-lesions, 392 cBHs, 426 p-, and 213 d-NAWM ROIs in patients, and 162 NWM ROIs in HCs. PSR differed significantly in all comparisons, while RD was differed in all except cBHs vs. T-lesions (P = 0.051). PSR had significantly higher accuracy in differentiating T-lesions from p/dNAWM and NWM, with a larger ES when comparing T-lesions to p/dNAWM and NWM and cBHs to pNAWM and NWM.
PSR offers superior accuracy and ES over RD in detecting tissue injury in MS.
1 TECHNICAL EFFICACY: Stage 2.
选择性反转恢复定量磁化传递（SIR-qMT）得出的大分子与自由水池大小比（PSR）以及扩散张量成像（DTI）得出的径向扩散率（RD）是评估多发性硬化症（MS）中髓鞘完整性的潜在指标。然而，确定它们在识别组织损伤方面的准确性对于临床转化至关重要。
比较PSR和RD在检测和量化早期MS组织损伤中的准确性和科恩效应量（ES）。
横断面前瞻性研究。
43例新诊断的MS患者（平均年龄38±11岁，70%为女性）和18例年龄和性别匹配的健康对照者（HCs；年龄38±12岁，62.5%为女性）。
场强/序列：使用T加权（T-w）快速自旋回波、T-w液体衰减反转恢复（FLAIR）、DTI和SIR-qMT序列的3-T MRI。
T2加权液体衰减反转恢复序列（T-w-FLAIR）上的高信号被识别为T2病灶，同时具有T-w-FLAIR高信号和T-w低信号的为慢性黑洞（cBHs）。正常表现白质（NAWM）中的感兴趣区域（ROIs）根据与病灶的距离分为近端（p）或远端（d），而在HCs中识别出正常白质（NWM）。将T2病灶和cBHs的PSR和RD值与其在HCs中匹配的p/dNAWM和NWM进行比较。同时也对T2病灶和cBHs进行了比较。
受试者工作特征曲线评估指标准确性，配对t检验比较PSR和RD的ES值，显著性设定为P<0.050。
我们在患者中识别出823个T2病灶、3
