隔层变化是否会根据多发性硬化症的诊断标准影响分类?
Nima Mahmoudi1,2, Julius Renne2, Franz Felix Konen3
1Department of Neuroradiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany.
European journal of neurology
|January 23, 2026
概括
多发性硬化症 (MS) 病变识别的研究人员之间的协议有所不同,应用诊断标准的一致性比病变数量更高. 标准化MRI协议显示中度至实质性的损伤存在的协议.
科学领域:
- 神经学 神经学
- 放射学 放射学是一门学科.
- 医疗成像医学成像
背景情况:
- 有限和过时的研究存在于MRI分析中的interrater协议,用于早期多发性硬化症 (MS) 诊断.
- 这项研究解决了对MRI病变识别协议的当前数据的需求.
研究的目的:
- 评估在早期MS中对大脑,视神经和脊髓损伤的识别进行interrater协议.
- 评估应用2017年和2024年麦克唐纳标准用于MS诊断的变异性.
主要方法:
- 78名患有第一个临床发作暗示MS的患者接受了标准化的3特斯拉MRI.
- 三位具有不同专业知识的读者分析了大脑,视神经和脊髓中的病变.
- 使用科恩的 κ 和弗莱斯的 κ. 量化了间隔者变异性.
主要成果:
- 对于病变总数,病变间的协议是轻微到相当的,但对于病变的存在是中度到实质性的.
- 对于脊髓损伤 (κ=0.84),周周结膜T2损伤 (κ=0.70) 和增强脑损伤 (κ=0.75) 观察到的最高一致性.
- 在2017年和2024年麦当劳标准修订之间发现了实质性的协议 (κ=0.65).
结论:
- 标准化的3T核磁共振 (MRI) 协议并没有显著改善早期多发性硬化症患者的病变数量.
- 根据诊断标准对病变的分类协议在2017年和2024年麦当劳标准之间保持一致.
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