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
{"title":"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","authors":"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","doi":"10.1002/jmri.29583","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Purpose: </strong>To conduct a multiparametric MRI analysis of PRLs.</p><p><strong>Study type: </strong>Retrospective/longitudinal.</p><p><strong>Subjects: </strong>Ninety-five progressive MS subjects with at least one persistent PRL who were enrolled in the CONSONANCE trial.</p><p><strong>Field strength/sequence: </strong>3-T/Susceptibility-weighted, T1-weighted, T2-weighted, and fluid-attenuated inversion recovery.</p><p><strong>Assessment: </strong>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.</p><p><strong>Statistical tests: </strong>Linear mixed models. A P-value <0.05 was considered significant.</p><p><strong>Results: </strong>There was a significant decrease in sT1w/T2w (-0.24 ± -5.3 × 10<sup>-3</sup>) 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<sup>-3</sup> ± 1.2 × 10<sup>-4</sup>) and rim (+5.6 × 10<sup>-3</sup> ± 1.2 × 10<sup>-4</sup>) 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<sup>-4</sup> ± 2.0 × 10<sup>-5</sup>) and rim (-2.4 × 10<sup>-4</sup> ± 2.0 × 10<sup>-5</sup>), indicative of irreversible tissue damage. Significant positive correlations between PRL core and rim sT1w/T2w (R<sup>2</sup> = 0.53), R2* (R<sup>2</sup> = 0.69) and QS (R<sup>2</sup> = 0.52) were observed.</p><p><strong>Data conclusion: </strong>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.</p><p><strong>Level of evidence: </strong>2 TECHNICAL EFFICACY: Stage 3.</p>","PeriodicalId":3,"journal":{"name":"ACS Applied Electronic Materials","volume":null,"pages":null},"PeriodicalIF":4.3000,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Longitudinal Multiparametric Quantitative MRI Evaluation of Acute and Chronic Multiple Sclerosis Paramagnetic Rim Lesions.\",\"authors\":\"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\",\"doi\":\"10.1002/jmri.29583\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Purpose: </strong>To conduct a multiparametric MRI analysis of PRLs.</p><p><strong>Study type: </strong>Retrospective/longitudinal.</p><p><strong>Subjects: </strong>Ninety-five progressive MS subjects with at least one persistent PRL who were enrolled in the CONSONANCE trial.</p><p><strong>Field strength/sequence: </strong>3-T/Susceptibility-weighted, T1-weighted, T2-weighted, and fluid-attenuated inversion recovery.</p><p><strong>Assessment: </strong>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.</p><p><strong>Statistical tests: </strong>Linear mixed models. A P-value <0.05 was considered significant.</p><p><strong>Results: </strong>There was a significant decrease in sT1w/T2w (-0.24 ± -5.3 × 10<sup>-3</sup>) 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<sup>-3</sup> ± 1.2 × 10<sup>-4</sup>) and rim (+5.6 × 10<sup>-3</sup> ± 1.2 × 10<sup>-4</sup>) 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<sup>-4</sup> ± 2.0 × 10<sup>-5</sup>) and rim (-2.4 × 10<sup>-4</sup> ± 2.0 × 10<sup>-5</sup>), indicative of irreversible tissue damage. Significant positive correlations between PRL core and rim sT1w/T2w (R<sup>2</sup> = 0.53), R2* (R<sup>2</sup> = 0.69) and QS (R<sup>2</sup> = 0.52) were observed.</p><p><strong>Data conclusion: </strong>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.</p><p><strong>Level of evidence: </strong>2 TECHNICAL EFFICACY: Stage 3.</p>\",\"PeriodicalId\":3,\"journal\":{\"name\":\"ACS Applied Electronic Materials\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2024-09-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ACS Applied Electronic Materials\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/jmri.29583\",\"RegionNum\":3,\"RegionCategory\":\"材料科学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ENGINEERING, ELECTRICAL & ELECTRONIC\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ACS Applied Electronic Materials","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jmri.29583","RegionNum":3,"RegionCategory":"材料科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENGINEERING, ELECTRICAL & ELECTRONIC","Score":null,"Total":0}
Longitudinal Multiparametric Quantitative MRI Evaluation of Acute and Chronic Multiple Sclerosis Paramagnetic Rim Lesions.
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.
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