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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
Pt 10
pubmed:dateCreated
2003-9-8
pubmed:abstractText
The correlation between conventional MRI lesion load accumulation and multiple sclerosis clinical evolution is only modest. The assessment of brain parenchymal volume and of its changes over time may provide adjunctive MRI markers reflecting the more disabling aspects of multiple sclerosis pathology. Magnetization transfer (MT) MRI is sensitive to 'occult' multiple sclerosis-related brain damage and might also contribute to overcome the clinical/MRI paradox. In this study, we assessed the value of conventional and MT MRI-derived metrics in predicting the medium-term clinical evolution of patients with different multiple sclerosis phenotypes. We studied 73 patients, with relapsing-remitting multiple sclerosis (n = 34), secondary progressive multiple sclerosis (n = 19) and clinically isolated syndromes suggestive of multiple sclerosis (n = 20), and 16 healthy subjects. Brain dual-echo, T1-weighted (only in patients) and MT MRI scans were obtained at baseline and after 12 months. T2-hyperintense and T1-hypointense lesion volumes, normalized brain volume and average lesion MT ratio (MTR) were measured. MTR histograms from the whole brain tissue were also obtained. Clinical multiple sclerosis evolution and neurological disability were re-assessed in all patients after a median follow-up of 4.5 years. A multivariate analysis was performed to establish which clinical and MRI-derived variables were significant predictors of neurological deterioration at the end of the study period. At the end of follow-up, 34 patients showed significant neurological deterioration. The final multivariable model included average brain MTR percentage change after one year [P = 0.02, odds ratio (OR) = 0.86] and baseline T2-hyperintense lesion volume (P = 0.04, OR=1.04) as independent predictors of medium-term disability accumulation (r2 = 0.23). In this cohort of patients, abnormal values of average brain MTR changes showed a relatively high specificity (76.9%) and positive predictive value (59.1%) for Expanded Disability Status Scale score deterioration in individual cases. In patients with multiple sclerosis, a comprehensive estimation of the short-term changes of both conventional and MT MRI-detectable lesion burden might provide useful prognostic information for the medium-term clinical disease evolution.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:status
MEDLINE
pubmed:month
Oct
pubmed:issn
0006-8950
pubmed:author
pubmed:issnType
Print
pubmed:volume
126
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
2323-32
pubmed:dateRevised
2004-11-17
pubmed:meshHeading
pubmed-meshheading:12937086-Adult, pubmed-meshheading:12937086-Analysis of Variance, pubmed-meshheading:12937086-Brain, pubmed-meshheading:12937086-Case-Control Studies, pubmed-meshheading:12937086-Disease Progression, pubmed-meshheading:12937086-Female, pubmed-meshheading:12937086-Follow-Up Studies, pubmed-meshheading:12937086-Humans, pubmed-meshheading:12937086-Image Interpretation, Computer-Assisted, pubmed-meshheading:12937086-Magnetic Resonance Imaging, pubmed-meshheading:12937086-Male, pubmed-meshheading:12937086-Middle Aged, pubmed-meshheading:12937086-Multiple Sclerosis, Relapsing-Remitting, pubmed-meshheading:12937086-Multivariate Analysis, pubmed-meshheading:12937086-Predictive Value of Tests, pubmed-meshheading:12937086-Prognosis, pubmed-meshheading:12937086-Sensitivity and Specificity
pubmed:year
2003
pubmed:articleTitle
Conventional and magnetization transfer MRI predictors of clinical multiple sclerosis evolution: a medium-term follow-up study.
pubmed:affiliation
Neuroimaging Research Unit, Department of Neuroscience, Scientific Institute and University Ospedale San Raffaele, Milan, Italy.
pubmed:publicationType
Journal Article