Toubasi Ahmad A, Graham Marc, Cutter Gary, Gheen Caroline, Vinarsky Taegan, Wang Jiacheng, Zhang Jessica, Taylor Stephanie, Eaton James E, Dortch Richard D, Xu Junzhong, Bagnato Francesca
Neuroimaging Unit, Neuroimmunology Division, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.
Lake Erie College of Osteopathic Medicine, Bradenton, FL, USA.
Mult Scler. 2025 Sep;31(10):1205-1217. doi: 10.1177/13524585251364766. Epub 2025 Sep 1.
The selective inversion recovery quantitative magnetization transfer imaging-derived macromolecular-to-free pool size ratio (PSR) and the magnetization transfer imaging-derived magnetization transfer ratio (MTR) are both indirect indicators of myelin integrity. However, it remains unknown whether the two measures perform equally in clinical studies.
To compare the accuracy and effect size (ES) of PSR and MTR in assessing white matter (WM) injury in the brain of people with multiple sclerosis (PwMS).
MTR and PSR were measured in lesions and normal-appearing white matter (NAWM) of 40 PwMS and in the normal white matter (NWM) of 16 healthy controls (HCs).
In total, 231 T-lesions, 257 chronic black holes (cBHs), 450 regions of interest (ROIs) in NAWM proximal (pNAWM) and distant (dNAWM) to lesions of PwMS, and 150 NWM ROIs of HCs were assessed. PSR was more accurate ( ⩽ 0.046) and had higher ES ( < 0.001) than MTR in differentiating T-lesions from pNAWM, dNAWM, or NWM. PSR was more accurate ( = 0.006) than MTR in differentiating cBHs from NWM and showed higher ES ( = 0.003) when comparing cBHs with pNAWM and dNAWM.
PSR has greater accuracy and ES than MTR in distinguishing WM areas with different degrees of tissue injury.
选择性反转恢复定量磁化传递成像得出的大分子与自由池大小比（PSR）和磁化传递成像得出的磁化传递比（MTR）均为髓鞘完整性的间接指标。然而，在临床研究中这两种测量方法的表现是否相同仍不清楚。
比较PSR和MTR评估多发性硬化症患者（PwMS）脑白质（WM）损伤的准确性和效应量（ES）。
对40例PwMS的病灶和正常外观白质（NAWM）以及16例健康对照者（HCs）的正常白质（NWM）进行MTR和PSR测量。
共评估了231个T2病灶、257个慢性黑洞（cBHs）、PwMS病灶近端（pNAWM）和远端（dNAWM）的450个NAWM感兴趣区（ROIs）以及HCs的150个NWM ROIs。在区分T2病灶与pNAWM、dNAWM或NWM时，PSR比MTR更准确（P⩽0.046）且效应量更高（P<0.001）。在区分cBHs与NWM时，PSR比MTR更准确（P = 0.006），并且在比较cBHs与pNAWM和dNAWM时显示出更高的效应量（P = 0.003）。
在区分不同程度组织损伤的WM区域时，PSR比MTR具有更高的准确性和效应量。
