Conventional magnetic resonance sequences in multiple sclerosis.

S Bastianello
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引用次数: 2

Abstract

The role of magnetic resonance imaging (MRI) in multiple sclerosis (MS) has received considerable attention in recent years. MRI has the potential to provide indices of disease activity and progression in clinical trials. Moreover, there is now widespread agreement that conventional MRI sequences are useful not only in diagnosing the disease but also in evaluating the natural course of the disease and the response to therapy. Conventional spin echo (CSE) sequences are widely accepted as sensitive techniques for the evaluation and quantification of brain MS lesions. Fast spin echo (FSE) sequences are now used as an alternative to CSE. They have the advantage of a considerable reduction in imaging time. Fast-fluid attenuation inversion recovery (fast-FLAIR) sequences, in which the signal from cerebrospinal fluid is suppressed, also provide a reliable means to evaluate the total lesion burden in patients with MS. Despite some limitations in the detection of infratentorial lesions, Fast-FLAIR sequences are useful in clinical studies. Compared with lesions load on conventional T2-weighted sequences, an increase in hypointense lesion load on CSE T1-weighted sequences correlates more strongly with increased disability in MS patients. This might be an additional useful MRI parameter to monitor disease progression in long-term studies. Gadolinium-enhanced T1-weighted images provide highly sensitive markers for detecting MRI activity, which represent the primary MRI endpoint for screening promising disease-modifying therapies, especially in phase II trials.

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多发性硬化症的常规磁共振序列。
近年来,磁共振成像(MRI)在多发性硬化症(MS)中的作用受到了相当大的关注。MRI有可能在临床试验中提供疾病活动和进展的指标。此外,现在普遍认为,传统的MRI序列不仅在诊断疾病方面有用,而且在评估疾病的自然过程和对治疗的反应方面也有用。传统的自旋回波(CSE)序列被广泛接受为评估和定量脑MS病变的敏感技术。快速自旋回波(FSE)序列现在被用作CSE的替代方案。它们的优点是成像时间大大缩短。快速流体衰减反转恢复(fast-FLAIR)序列,其中脑脊液信号被抑制,也提供了一种可靠的手段来评估ms患者的总病变负担,尽管在幕下病变的检测方面存在一些局限性,但fast-FLAIR序列在临床研究中是有用的。与传统t2加权序列的病变负荷相比,CSE t1加权序列的低信号病变负荷增加与MS患者残疾增加的相关性更强。在长期研究中,这可能是监测疾病进展的一个额外有用的MRI参数。钆增强t1加权图像为检测MRI活动提供了高度敏感的标记,这是筛选有希望的疾病改善疗法的主要MRI终点,特别是在II期试验中。
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