Diffusion- and Tractography-Based Characterization of Tissue Damage Within and Surrounding Paramagnetic Rim Lesions in Multiple Sclerosis.

Maryam Mohebbi, Jack A Reeves, Dejan Jakimovski, Alexander Bartnik, Niels Bergsland, Fahad Salman, Ferdinand Schweser, Bianca Weinstock-Guttman, Robert Zivadinov, Michael G Dwyer
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Abstract

Background and purpose: Paramagnetic rim lesions (PRLs) are an imaging biomarker of chronic inflammation in MS that are associated with more aggressive disease. However, the precise tissue characteristics and extent of their damage, particularly with regard to connected axonal tracts, are incompletely understood. Quantitative diffusion tissue measurements and fiber tractography can provide a more complete picture of these phenomena.

Materials and methods: One hundred fifteen people with MS were enrolled in this study. Quantitative susceptibility mapping and DWI were acquired on a 3T MRI scanner. PRLs were identified in 49 (43%) subjects. Diffusion tractography was then used to identify nearby PRL-connected versus non-PRL connected tracts and PRL-connected versus nonconnected surrounding tracts. DWI metrics, including fractional anisotropy (FA), quantitative anisotropy (QA), mean diffusivity, axial diffusivity, radial diffusivity, isotropy, and restricted diffusion imaging, were compared between these tracts and within PRLs and non-PRL lesions themselves.

Results: Tissue within PRLs had significantly lower FA than tissue within non-PRL T2 lesions (P = .04). Tracts connected to PRLs exhibited significantly lower FA (P < .001), higher restricted diffusion imaging (P = .02, and higher Iso values (P = .007) than tracts connected to non-PRL T2 lesions. Only QA was different between tracts connected to PRLs and nonconnected surrounding tracts (P = .003).

Conclusions: PRLs are more destructive both within themselves and to surrounding tissue. This damage appears more spatially than axonally mediated.

多发性硬化症顺磁边缘病变内及周围组织损伤的扩散和束状图表征。
背景和目的:顺磁边缘病变(prl)是多发性硬化症慢性炎症的影像学生物标志物,与更具侵袭性的疾病相关。然而,其确切的组织特征和损伤程度,特别是连接的轴突束,尚不完全清楚。定量扩散组织测量和纤维束造影可以提供这些现象的更完整的图像。材料与方法:115例多发性硬化症患者纳入本研究。在3T MRI扫描仪上获得定量敏感性图和DWI。在49例(43%)受试者中发现prl。然后使用弥散束造影来识别附近prl连接束与非prl连接束以及prl连接束与非连接束的周围束。DWI指标,包括分数各向异性(FA)、定量各向异性(QA)、平均扩散率、轴向扩散率、径向扩散率、各向同性和受限扩散成像,比较了这些束之间以及prl和非prl病变本身。结果:prl内组织FA明显低于非prl T2病变组织FA (P = 0.04)。与非prl T2病变相比较,与prl T2病变相连接的动脉束表现出更低的FA (P < 0.001),更高的受限扩散成像(P = 0.02)和更高的Iso值(P = 0.007)。只有与prl连接的束与周围未连接的束之间的QA不同(P = 0.003)。结论:prl对自身及周围组织的破坏更大。这种损伤更多表现为空间介导而非轴突介导。
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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