多发性硬化和视神经脊髓炎谱系疾病的脉络丛体积变化

Choroid plexus volume in multiple sclerosis and neuromyelitis optica spectrum disorders

目的探讨脉络丛(ChP)体积在多发性硬化(MS)和视神经脊髓炎谱系疾病(NMOSD)中的变化及其临床意义。方法选取110例MS患者(MS组)、110例NMOSD患者(NMOSD组)和130例健康志愿者(HC组)的三维结构像。应用深度学习算法自动分割侧脑室脉络丛,比较三组之间的ChP体积差异。进一步研究脉络丛体积与脑白质高信号体积及临床指标的相关性。结果MS组和NMOSD组患者的标准化ChP体积较HC组显著增大,MS的ChP体积比NMOSD患者显著增大。两组患者标准化ChP体积均与脑白质高信号的体积明显相关,与临床残疾状态量表(EDSS)相关。MS患者增大的ChP体积与符号数字转换测验(SDMT)评分相关,NMOSD患者增大的ChP体积与同步听觉连续加法测验(PASAT)评分相关。结论MS和NMOSD均显示为侧脑室的ChP体积增大,而两种疾病脉络丛增大的程度不同,MS更为显著。ChP体积与临床躯体残疾及认知损害相关,有望作为评估神经炎性疾病的潜在MRI标记物。

Objective To compare the choroid plexus(ChP)volume in patients with multiple sclerosis(MS)and neuromyelitis optica spectrum disorders(NMOSD),and to assess the clinical significance.Methods Three-dimensional T_(1)-weighted MRI were acquired,including 110 ms,110 NMOSD and 130 healthy controls(HC).The ChP of the lateral ventricles was segmented fully automatically on T_(1)-weighted MRI sequences using a deep learning algorithm and compared between disease groups and HC.Spearman correlation analysis was applied to investigate the associations between ChP volume〔ratio of total intracranial volume(TIV)〕,white matter hyperintensities(WMH)volume and clinical variables for MS and NMOSD.Results Patients with MS,NMOSD had larger ChP volume than age-and sex-matched HC.ChP volume was higher in MS patients than that in NMOSD patients.ChP volume was correlated with WMH volume and EDSS scores in both disease groups.For the clinical relevance,the increased ChP volume was associated with Symbol Digit Modalities Test(SDMT)in MS,with Paced Auditory Serial Addition Task(PASAT)in NMOSD patients.Conclusion This study demonstrates ChP enlargement is a common feature in MS and NMOSD,and MS is much more significant.ChP volume is correlated with clinical disability and cognitive impairment,which could serve as a potential MRI marker for assessing neurological diseases.