临床孤立综合征的MRI扫描基线:预测残疾15年后(S45.002)

文摘

摘要目的:探讨MRI基线预测长期残疾的患者临床孤立综合征(CIS)。背景:基线T2-hyperintense病变数量只是一个温和的预测长期残疾患者的CIS。措施的大脑病变位置/活动和萎缩与残疾有关中短期内(5 - 7年),但它们如何与长期的结果是未知的。方法:178例患者(平均年龄32.3岁,114名女性)有3个月内MRI的独联体和随访15年后。基线MRI变量包括损伤指标负载(大脑T2-hyperintense和T1-hypointense病变数量和体积),病变位置(室、juxtacortical infratentorial,脊髓),病变活动(钆增强病灶数)和萎缩(正常化整个大脑灰质和白质体积+上颈线横截面积)。独联体病变症状被排除在外。在随访,女士被诊断使用麦当劳2010标准和残疾用扩大残疾状态量表(eds)。重大残疾15年后被定义为eds≥3。单变量和多变量二元逻辑回归是用来确定MRI长期残疾的预测因子。结果:164例患者(92 [percnt])随访后平均15.1年; 119 (73[percnt]) developed multiple sclerosis (MS) and 45 (27[percnt]) remained CIS. 42 (26[percnt]) patients had an EDSS ≥3. In the multivariable model, baseline brain T2 lesion number (odds ratio [OR] 1.81, p=0.003) and baseline spinal cord lesions (OR 3.77, p=0.001) were independently associated with disability. Only spinal cord lesions were associated with disability in patients who developed MS (OR 2.73, p=0.013). Conclusions: In this cohort with uniquely long follow-up, asymptomatic spinal cord lesions at the time of CIS were most strongly associated with disability after 15 years. These findings suggest that spinal cord lesions may be an important factor underpinning long-term disability in relapse-onset MS.

披露:Brownlee博士没有披露。•阿尔特曼博士没有披露。Wheeler-Kingshott博士已经收到个人活动与生原体补偿Idec担任顾问。博士Wheeler-Kingshott女士收到了来自英国的研究支持社会,伦敦大学学院/ UCLH NIHR, BRC, EPSRC, ISRT,翅膀,和新西兰的大脑R Miszkiel博士没有披露。Ciccarelli博士已经与诺华收到个人补偿活动,生原体和通用电气作为顾问。米勒博士没有披露。