Longitudinal Multiparametric Quantitative MRI Evaluation of Acute and Chronic Multiple Sclerosis Paramagnetic Rim Lesions.

IF 3.3 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Journal of Magnetic Resonance Imaging Pub Date : 2024-09-06 DOI:10.1002/jmri.29583

Ahmed M Elkady, Colm Elliott, Dumitru Fetco, David Araujo, Zahra Karimaghaloo, Marco Ganzetti, David Clayton, Licinio Craveiro, Agne Kazlauskaite, Sridar Narayanan, Douglas L Arnold, David A Rudko

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Abstract

Background: Multiple sclerosis (MS) paramagnetic rim lesions (PRLs) are markers of chronic active biology and exhibit complex iron and myelin changes that may complicate quantification when using conventional MRI approaches.

Purpose: To conduct a multiparametric MRI analysis of PRLs.

Study type: Retrospective/longitudinal.

Subjects: Ninety-five progressive MS subjects with at least one persistent PRL who were enrolled in the CONSONANCE trial.

Field strength/sequence: 3-T/Susceptibility-weighted, T1-weighted, T2-weighted, and fluid-attenuated inversion recovery.

Assessment: Acute/chronic PRLs and non-PRLs were measured at screening, 24, 48, and 96 weeks using quantitative magnetic susceptibility (QS), R2*, and standardized T1w/T2w ratio (sT1w/T2w). PRL analyses were performed for whole lesion, core, and rim. The correlations between PRL core and rim sT1w/T2w, QS, and R2* were assessed.

Statistical tests: Linear mixed models. A P-value <0.05 was considered significant.

Results: There was a significant decrease in sT1w/T2w (-0.24 ± -5.3 × 10^-3) and R2* (-3.6 ± 2.2 Hz) but a significant increase in QS (+21 ± 1.3 ppb) using whole-lesion analysis of chronic PRLs compared to non-PRLs at screening. Tissue damage accumulated at the 96-week time point was more evident in acute/chronic PRLs compared to acute/chronic non-PRLs (ΔsT1w/T2w = -0.21/-0.24 ± 0.033/0.0053; ΔR2* = -4.4/-3.6 ± 1.4/2.2 Hz). New, acute PRL sT1w/T2w significantly increased in lesion core (+4.3 × 10^-3 ± 1.2 × 10^-4) and rim (+5.6 × 10^-3 ± 1.2 × 10^-4) 24 weeks post lesion inception, suggestive of partial recovery. Chronic PRLs, contrastingly, showed significant decreases in sT1w/T2w over the initial 24 weeks for both core (-2.1 × 10^-4 ± 2.0 × 10^-5) and rim (-2.4 × 10^-4 ± 2.0 × 10^-5), indicative of irreversible tissue damage. Significant positive correlations between PRL core and rim sT1w/T2w (R² = 0.53), R2* (R² = 0.69) and QS (R² = 0.52) were observed.

Data conclusion: Multiparametric assessment of PRLs has the potential to be a valuable tool for assessing complex iron and myelin changes in chronic active PRLs of progressive MS patients.

Level of evidence: 2 TECHNICAL EFFICACY: Stage 3.

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对急性和慢性多发性硬化症顺磁边缘病变的纵向多参数定量 MRI 评估

背景：多发性硬化症（MS）顺磁性边缘病变（PRLs）是慢性活动性生物标志物，表现出复杂的铁和髓鞘变化，这可能使传统 MRI 方法的量化变得复杂：研究类型：回顾性/纵向研究：研究类型：回顾性/纵向研究。受试者：95名进展期多发性硬化症受试者，他们至少有一个持续性PRL，并参加了CONSONANCE试验：3-T/感度加权、T1加权、T2加权和液体衰减反转恢复：在筛查、24、48 和 96 周时使用定量磁感应强度 (QS)、R2* 和标准化 T1w/T2w 比值 (sT1w/T2w) 测量急性/慢性 PRL 和非 PRL。对整个病灶、核心和边缘进行了 PRL 分析。评估了 PRL 核心和边缘 sT1w/T2w、QS 和 R2* 之间的相关性：线性混合模型。A P值结果：与筛查时的非PRL相比，通过对慢性PRL进行全组织分析，sT1w/T2w（-0.24 ± -5.3 × 10-3）和R2*（-3.6 ± 2.2 Hz）明显下降，但QS（+21 ± 1.3 ppb）明显上升。与急性/慢性非 PRL 相比，急性/慢性 PRL 在 96 周时间点累积的组织损伤更为明显（ΔsT1w/T2w = -0.21/-0.24 ± 0.033/0.0053；ΔR2* = -4.4/-3.6 ± 1.4/2.2 Hz）。新的急性PRL sT1w/T2w在病变开始后24周在病变核心（+4.3 × 10-3 ± 1.2 × 10-4）和边缘（+5.6 × 10-3 ± 1.2 × 10-4）显著增加，提示部分恢复。相反，慢性 PRL 在最初的 24 周内，核心（-2.1 × 10-4 ± 2.0 × 10-5）和边缘（-2.4 × 10-4 ± 2.0 × 10-5）的 sT1w/T2w 均显著下降，表明组织损伤不可逆转。在 PRL 核心和边缘 sT1w/T2w (R2 = 0.53)、R2* (R2 = 0.69) 和 QS (R2 = 0.52) 之间观察到显著的正相关：数据结论：PRL的多参数评估有可能成为评估进展期多发性硬化症患者慢性活动性PRL中复杂的铁和髓鞘变化的重要工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Magnetic Resonance Imaging 医学-核医学

CiteScore

9.70

自引率

6.80%

发文量

494

审稿时长

2 months

期刊介绍： The Journal of Magnetic Resonance Imaging (JMRI) is an international journal devoted to the timely publication of basic and clinical research, educational and review articles, and other information related to the diagnostic applications of magnetic resonance.