AJNR. American journal of neuroradiology · 2026
Understanding the Therapeutic Impact of Disease-Modifying Therapies or No Treatment on Enlarging T1-Weighted Hypointense Lesions and Total T1-Weighted Hypointense Lesion Volume in MS.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Okuda Darin T, Punnen Tom G, Moog Tatum M, McCreary Morgan C, Burgess Katy W, Lebrun-Frénay Christine
Аннотация
BACKGROUND AND PURPOSE: T1-weighted hypointense lesions resulting from MS reflect chronic, irreversible tissue injury mediated by autoimmune inflammation and are associated with neurologic disability. The evolution of such lesions is heterogeneous in the presence or absence of disease-modifying therapy (DMT). We investigated dynamic changes of T1-weighted hypointense lesions along with total T1-weighted hypointense lesion volumes to further understand MRI features that may reflect clinically silent disease activity.
MATERIALS AND METHODS: A retrospective study was performed involving people with MS with 3 consecutive standardized MRI time points within a single academic center. Individuals with formal neuroradiology interpretations lacking evidence of T1-weighted hypointense lesion change were included. Approximately 8-12 nongadolinium-enhancing T1-weighted hypointense lesions measuring at least 3 mm2 were selected from a 3D MPRAGE from each individual. Total T1-weighted hypointense lesion volumes were also quantified at each time point. The Lambda, Mu, and Sigma method was used to estimate the SD of the annualized volume rate of change as a function of the lesion volume at the prior time point. The longitudinal associations between treatment class on T1-weighted hypointense lesion dynamics and relationship to patient- or physician-reported disease worsening, acute clinical relapse, and MRI advancement were evaluated.
RESULTS: The cohort comprised 91 people (71.4% women; mean disease duration of 9.32 years; SD: 7.22 years) who were primarily white (80.2%). Of treated individuals, most were exposed to non-high-efficacy DMTs at least once (48.4%). In total, 273 MRI studies yielding 790 T1-weighted hypointensities were studied longitudinally. Predominantly enlarging T1-weighted hypointense lesions were seen in 82.4% of individuals over 3 MRI time points. The odds of overall T1-weighted lesion volume contraction did not differ between those on high-efficacy treatment (P = .71) or those untreated (P = .85), compared with non-high-efficacy agents. Treatment group did not influence total change in T1-weighted hypointense lesion volumes, and correlations with clinical or MRI outcomes were not observed.
CONCLUSIONS: Current DMT classifications may have minimal influence on T1-weighted hypointense outcomes, highlighting the need for treatments that directly target ongoing tissue injury.
MATERIALS AND METHODS: A retrospective study was performed involving people with MS with 3 consecutive standardized MRI time points within a single academic center. Individuals with formal neuroradiology interpretations lacking evidence of T1-weighted hypointense lesion change were included. Approximately 8-12 nongadolinium-enhancing T1-weighted hypointense lesions measuring at least 3 mm2 were selected from a 3D MPRAGE from each individual. Total T1-weighted hypointense lesion volumes were also quantified at each time point. The Lambda, Mu, and Sigma method was used to estimate the SD of the annualized volume rate of change as a function of the lesion volume at the prior time point. The longitudinal associations between treatment class on T1-weighted hypointense lesion dynamics and relationship to patient- or physician-reported disease worsening, acute clinical relapse, and MRI advancement were evaluated.
RESULTS: The cohort comprised 91 people (71.4% women; mean disease duration of 9.32 years; SD: 7.22 years) who were primarily white (80.2%). Of treated individuals, most were exposed to non-high-efficacy DMTs at least once (48.4%). In total, 273 MRI studies yielding 790 T1-weighted hypointensities were studied longitudinally. Predominantly enlarging T1-weighted hypointense lesions were seen in 82.4% of individuals over 3 MRI time points. The odds of overall T1-weighted lesion volume contraction did not differ between those on high-efficacy treatment (P = .71) or those untreated (P = .85), compared with non-high-efficacy agents. Treatment group did not influence total change in T1-weighted hypointense lesion volumes, and correlations with clinical or MRI outcomes were not observed.
CONCLUSIONS: Current DMT classifications may have minimal influence on T1-weighted hypointense outcomes, highlighting the need for treatments that directly target ongoing tissue injury.