Abstract：
OBJECTIVE: Pediatric multiple sclerosis (MS) displays different pathological features compared to adult MS, which can be studied in vivo by assessing tissue magnetic susceptibility with 3T-MRI. We aimed to assess different white matter lesions (WMLs) phenotypes in pediatric MS patients using quantitative susceptibility mapping (QSM) and susceptibility mapping weighted imaging (SMWI) over 12 months.
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.
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.
摘要：
目的：小儿多发性硬化症（MS）与成人MS相比，表现出不同的病理特征，可以通过3T-MRI评估组织磁化率在体内进行研究。我们的目的是评估不同的白质病变（WMLs）表型在儿科MS患者使用定量磁敏感图（QSM）和磁敏感图加权成像（SMWI）超过12个月。
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。
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。
