Pietrock Charlotte, Knoche Theresia, Meidinger Sophia, Wenzel Victor, Neumann Konrad, Siebert Eberhard, Danyel Leon Alexander
Department of Neurology with Experimental Neurology, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
BMC Med Imaging. 2025 Jun 19;25(1):208. doi: 10.1186/s12880-025-01780-4.
To assess the utility of DWI-MRI to differentiate arteritic (A-AION) from non-arteritic (NA-AION) ischemic optic neuropathy.
This bicentric cohort-study evaluated 3T DWI-MRI scans performed within 10 days after onset of AION in patients treated between 2014 and 2024 at two tertiary care centers. DWI was first assessed for the presence of restricted diffusion within the optic nerve. Quantitative apparent diffusion coefficient (ADC) evaluation was performed by placing a region of interest (ROI) within the affected optic nerve. Qualitative and quantitative DWI assessments were compared between A-AION and NA-AION patients.
Twenty A-AION patients (75.7 ± 6.8 years; 16 [80.0%] female) and 59 NA-AION patients (64.6 ± 10.7 years; 22 [37.3%] female) with a total of 82 (A-AION: 23; NA-AION: 59) DWI-MRI scans were included in the study. Restricted diffusion on ADC was significantly more frequent in A-AION, when compared to NA-AION (82.6% vs. 42.4%; p = 0.001). Corresponding sensitivity, specificity, positive and negative predictive value of qualitative ADC assessment for the identification of A-AION were 0.83, 0.58, 0.43 and 0.89. Quantitative ADC analysis revealed significantly lower values in optic nerves affected by A-AION (ADC: 448.0 ± 256.2 × 10 mm/s vs. 671.5 ± 174.9 × 10 mm/s, p = 0.002).
Restricted diffusion of the optic nerve is more frequent in A-AION and associated with lower optic nerve ADC values, when compared to NA-AION. Prospective studies are required to further explore the potential of DWI in discerning arteritic from non-arteritic AION.
评估弥散加权成像磁共振成像（DWI-MRI）在鉴别动脉炎性（A-AION）与非动脉炎性（NA-AION）缺血性视神经病变中的应用价值。
这项双中心队列研究评估了2014年至2024年期间在两家三级医疗中心接受治疗的AION患者发病后10天内进行的3T DWI-MRI扫描。首先评估DWI上视神经内是否存在扩散受限。通过在患侧视神经内放置感兴趣区（ROI）进行定量表观扩散系数（ADC）评估。比较A-AION和NA-AION患者的定性和定量DWI评估结果。
本研究纳入了20例A-AION患者（75.7±6.8岁；16例[80.0%]为女性）和59例NA-AION患者（64.6±10.7岁；22例[37.3%]为女性），共82次DWI-MRI扫描（A-AION：23次；NA-AION：59次）。与NA-AION相比，A-AION中ADC上的扩散受限明显更常见（82.6%对42.4%；p=0.001）。定性ADC评估鉴别A-AION的相应敏感性、特异性、阳性和阴性预测值分别为0.83、0.58、0.43和0.89。定量ADC分析显示，受A-AION影响的视神经中的值明显更低（ADC：448.0±256.2×10⁻⁶mm²/s对671.5±174.9×10⁻⁶mm²/s，p=0.002）。
与NA-AION相比，A-AION中视神经的扩散受限更常见，且与较低的视神经ADC值相关。需要进行前瞻性研究以进一步探索DWI在区分动脉炎性与非动脉炎性AION方面的潜力。
