Filippi M, Sormani M P, Rovaris M, Comi G
Department of Neurology, Scientific Institute Ospedale San Raffaele, University of Milan, Italy.
Magn Reson Imaging. 1998 Dec;16(10):1181-3. doi: 10.1016/s0730-725x(98)00083-6.
Although lesion load changes on conventional T2-weighted brain magnetic resonance imaging (MRI) scans from patients with multiple sclerosis (MS) are used to monitor the effect of treatment, there is no clear definition of how lesion load changes over years according to the lesion load present at a baseline evaluation. In the present study, we evaluated the relationship between lesion load changes over time and lesion load at a baseline evaluation in a group of untreated patients with MS. We scanned nineteen patients on two separate occasions with a mean interval 16.4 months between the two examinations. In each scanning session, a scan with forty contiguous 3-mm-thick axial slices was acquired. We assessed MRI lesion loads using a semi-automated local thresholding technique. Both a linear (p < 0.0001) and a quadratic component (p = 0.0008) of the baseline volume were significant in describing the follow-up volume. The equation to model this finding was as follows: Vf = beta0 Vb + beta1 (Vb)2, where Vf is the lesion volume at follow-up, Vb is the lesion volume at baseline, beta0 = 0.834 (SE = 0.098), and beta1 = 0.014 (SE = 0.003) (mL)(-1). Our data indicate that lesion volume changes detectable on serial brain MRI studies from patients with MS are dependent on the extent of lesion burden present on the baseline MRI scans. This finding has to be considered when planning phase III trials.
尽管多发性硬化症（MS）患者常规T2加权脑磁共振成像（MRI）扫描中的病灶负荷变化用于监测治疗效果，但对于病灶负荷如何根据基线评估时的病灶负荷在数年中发生变化，尚无明确的定义。在本研究中，我们评估了一组未经治疗的MS患者病灶负荷随时间的变化与基线评估时病灶负荷之间的关系。我们在两个不同时间对19名患者进行了扫描，两次检查之间的平均间隔为16.4个月。在每次扫描过程中，获取了40个连续的3毫米厚轴向切片的扫描图像。我们使用半自动局部阈值技术评估MRI病灶负荷。基线体积的线性成分（p < 0.0001）和二次成分（p = 0.0008）在描述随访体积时均具有显著性。用于模拟这一发现的方程如下：Vf = beta0 Vb + beta1 (Vb)2，其中Vf是随访时的病灶体积，Vb是基线时的病灶体积，beta0 = 0.834（标准误 = 0.098），beta1 = 0.014（标准误 = 0.003）（mL）（-1）。我们的数据表明，MS患者连续脑MRI研究中可检测到的病灶体积变化取决于基线MRI扫描时存在的病灶负担程度。在规划III期试验时必须考虑这一发现。
