METHODS: Eleven pediatric MS patients [female: 63.6%; mean ± standard deviation (SD) age and disease duration: 16.3 ± 2.2 and 2.4 ± 1.5; median (range) Expanded Disability Status Scale (EDSS) 1 (0-2)] underwent 3 Tesla-MRI exams and EDSS assessments at baseline and after 1 year. QSM and SMWI were obtained using 3-dimensional (3D)-segmented echo-planar-imaging with submillimetric spatial resolution. WMLs were classified according to their QSM appearance and SMWI was used to identify QSM hyperintensities ascribable to veins. Total brain volumes at baseline and follow-up were computed using high-resolution 3D T1-weighted images.
RESULTS: Mean ± SD paramagnetic rim lesions (PRLs) prevalence was 7.0% ± 9.0. Fifty-four percent (6/11) of patients exhibited at least one PRL, with one patient exhibiting ≥ 4 PRLs. All patients showed QSM-iso-/hypo-intense lesions, which represented a mean ± SD of 65.8% ± 22.7 of total WMLs. QSM-hyperintense WMLs showed a positive correlation with total brain volume reduction at follow-up (r = 0.705; p = .02). No lesion was classified as different between baseline and follow-up.
CONCLUSIONS: Chronic compartmentalized inflammation seems to occur early in pediatric MS patients with short disease duration. A high prevalence of iso-/hypo-intense lesions was found, which could account for the higher remyelination potential in pediatric MS.
方法:11名儿科MS患者[女性:63.6%;平均±标准差(SD)年龄和病程:16.3±2.2和2.4±1.5;中位数(范围)扩展残疾状态量表(EDSS)1(0-2)]在基线和1年后接受了3次Tesla-MRI检查和EDSS评估。QSM和SMWI是使用具有亚毫米空间分辨率的3维(3D)分段回波平面成像获得的。WML根据其QSM外观进行分类,并使用SMWI来识别归因于静脉的QSM高强度。使用高分辨率3DT1加权图像计算基线和随访时的总脑体积。
结果:平均±SD顺磁性边缘病变(PRL)患病率为7.0%±9.0。54%(6/11)的患者表现出至少一个PRL,一名患者表现出≥4个PRL。所有患者均表现为QSM-等/低强度病变,这代表了总WML的65.8%±22.7的平均值±SD。QSM-高强度WMLs在随访时显示与总脑容积减少呈正相关(r=0.705;p=.02)。在基线和随访之间,没有病变被分类为不同。
结论:慢性房室化炎症似乎发生在病程短的儿童MS患者早期。发现等/低强度病变的患病率很高,这可以解释儿科MS的较高髓鞘再生潜力。