偏磁铁边缘病变作为多发性硬化症中残疾进展的预后因素:对文献的系统审查
Luis Alfonso Zarco1, Andrés Felipe Cárdenas-Cruz2, Óscar Muñoz3
1Neurologist-Neuroimmunologist Student, Master's Program in Multiple Sclerosis, Dresden International University, Dresden, Germany; Associate Professor of Neurology, Neuroscience Department, Division of Neurology, Pontificia Universidad Javeriana, Hospital Universitario San Ignacio, Bogotá, Colombia.
Multiple sclerosis and related disorders
|November 8, 2025
概括
偏磁边缘病变 (PRLs) 表明多发性硬化症 (MS) 进展的风险增加,即使没有复发. 在基线确定PRL可以为针对慢性炎症的新型MS疗法进行临床试验提供信息.
科学领域:
- 神经成像是一种神经成像.
- 神经学 神经学
- 生物标志物 生物标志物
背景情况:
- 慢性炎症导致多发性硬化症 (MS) 的残疾.
- 偏磁边缘病变 (PRL) 是慢性活跃病变 (CAL) 的成像标志物,也是MS严重程度的潜在生物标志物.
- 关于PRL和MS进展的现有证据受到小样本大小和短时间的随访时间的限制.
研究的目的:
- 评估通过MRI检测到的PRL是否预测MS患者的复发活动 (PIRA) 或确认残疾进展 (CDP) 独立的进展.
- 为了评估PRL,使用敏感度加权成像 (SWI),过阶段或定量敏感度映射 (QSM) 在3T或7TMRI.
主要方法:
- 在PubMed和Embase的系统文献搜索,寻找关于PRL和MS残疾进展的研究.
- 使用预后研究中的质量 (QUIPS) 工具进行质量评估.
- 使用推,评估,开发和评估 (GRADE) 框架对证据的确定性进行分级.
主要成果:
- 对744名患者的5项研究的分析显示,PRL与PIRA (OR 2.24) 和CDP (OR 2.87) 的风险更高相关.
- 在随访时间较短 (≤4年,OR2.84) 的研究中,PRL和PIRA之间的关联更为强烈.
- 证据的确定性对于PIRA是中等的,对于CDP是低的.
结论:
- 偏磁边缘病变 (PRLs) 与多发性硬化症进展的风险增加有关,特别是PIRA.
- PRLs作为一个潜在的成像生物标志物,用于预测MS残疾进展.
- 在针对慢性炎症和MS进展的临床试验中,建议对基线PRL进行评估.
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