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在多发性硬化症中出现正常的白质和残疾

Valentin N Stepanov^1,2, Santiago Coelho^1,2, Benjamin Ades-Aron^1,2

¹Bernard and Irene Schwartz Center for Biomedical Imaging, Department of Radiology, New York University Grossman School of Medicine, New York, NY, USA.

medRxiv : the preprint server for health sciences

|November 24, 2025

概括

扩散MRI (dMRI) 显示多发性硬化症 (MS) 中出现正常的白质损伤 (NAWM),与残疾相关. 像标准模型成像 (SMI) 这样的先进的dMRI指标为轴突损失和炎症提供了具体的见解.

科学领域:

神经成像是一种神经成像.
放射学放射学是一门学科.
神经学神经学

背景情况:

多发性硬化症 (MS) 常规MRI显示病变和缩,但这些并不能完全解释患者的残疾.
扩散核磁共振 (dMRI) 技术,如扩散张力成像 (DTI) 和形成像 (DKI) 检测微观结构损伤.
标准模型成像 (SMI) 从dMRI提供了生物学上可解释的参数.

研究的目的:

评估临床上可行的dMRI指标是否与体积和病变测量之外的MS残疾相关.
为了确定正常出现的白质 (NAWM) 中的微观结构损伤是否有助于MS相关的残疾.
评估SMI参数的附加值,以了解MS病理生理学.

主要方法:

在92名多发性硬化患者的横截面研究中,使用3TMRI和多dMRI协议.
分析包括大脑体积,病变负载和dMRI指标 (DTI-RD,DKI-RK,SMI-f,SMI-p2).
使用EDSS,MSFC,9HPT,SDMT和疾病持续时间评估的临床结果;分析经过调整以考虑混因素和重复排除病变.

主要成果:

dMRI指标显示与临床测量有广泛的关联,在病变排除后仍存在,涉及NAWM损伤.
特定的dMRI指标与不同的功能结果相关:9HPT与皮质脊髓管/光学辐射,MSFC与脑干/光学辐射.
EDSS与指导管道扩散和下损伤负荷相关;疾病持续时间与灰质缩和指导管纤维分散相关.

结论:

dMRI检测到NAWM损伤有助于MS的功能障碍,独立于缩和病变.
SMI参数 (f,p2) 提供了轴突损失,脱和炎症的特异性.
结合扩散,体积和病变指标的多式成像对于MS监测和分层非常有价值.

关键词:

大脑体积大脑体积大脑体积扩散曲解成像 (DKI) 是一种扩散曲解成像技术.扩散张力成像 (DTI) 是一种扩散张力成像技术.疾病的进展疾病的进展微结构病理学微结构病理学多发性硬化症 (MS) 是一种疾病.扩散的标准模型 (SMI)

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