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首页> 外文期刊>Neurology India. >Prognostic value of magnetic resonance imaging in patients with clinically isolated syndrome conversion to multiple sclerosis: A meta-analysis
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Prognostic value of magnetic resonance imaging in patients with clinically isolated syndrome conversion to multiple sclerosis: A meta-analysis

机译：磁共振成像对临床孤立综合征转化为多发性硬化症患者的预后价值：一项荟萃分析

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Background: Numerous studies have investigated the associations of brain or spinal cord MRI with the risk of developing Multiple Sclerosis (MS) in people with Clinically Isolated Syndrome (CIS), however, the findings are uncertain. Therefore, we performed a meta-analysis based on 24 publications to comprehensively evaluate such associations. Materials and Methods: The databases of EMBASE and MEDLINE (January 1980-August 2011) were searched electronically for all relevant studies. Data were extracted from each study independently by both reviewers using a predefined structured spreadsheet. The quality of each study was assessed independently by two reviewers according to Newcastle-Ottawa Scale for reading cohort study proposed by Deeks et al. The meta-analysis including 24 qualified studies was performed by using the Cochrane Collaborations RevMan5.0 software. Results: Twenty-four identified studies met the inclusion criteria and minimum quality threshold. A meta-analysis of cohort studies indicated that the CISs having MRI lesions did have significantly increased risk for MS (risk ratio [RR] = 3.71, 95% confidence interval [CI], 3.27-4.21, P < 0.00001). In the subgroup analysis (according to the number of T2 lesions at baseline), the risk of developing MS in CIS patients with the medium MRI burden (4-9 lesions) was higher than with the low MRI burden (1-3 lesions) (RR = 0.66,95% CI, 0.45-0.95, P < 0.00001). While, no correlation was found in group between the medium MRI burden and the high MRI burden(>9 lesions) (RR = 0.97, 95% CI, 0.82-1.15, P = 0.72). Meanwhile, the CIS patients with abnormal baseline MRI, especially with infratentorial lesions, had a high risk of conversion to MS compared to patients without the such infratentorial lesions (RR = 1.37, % CI, 1.09-1.73, P = 0.0008). Conclusions: Despite some limitations, this meta-analysis established solid statistical evidence for an association between the presence or absence of MRI lesions within the brain or spinal cord MRI and the risk of developing MS, particularly for studies with large sample size. The CIS patients with abnormal baseline MRI, especially with infratentorial lesions, had a high risk of conversion to MS. However, this association warrants additional validation in larger and well designed studies.
机译：背景：许多研究已经调查了脑或脊髓MRI与临床孤立综合征（CIS）患者发展为多发性硬化症（MS）的风险之间的关系，但是，这一发现尚不确定。因此，我们基于24个出版物进行了荟萃分析，以全面评估此类关联。材料和方法：通过电子方式搜索EMBASE和MEDLINE（1980年1月至2011年8月）的数据库以查找所有相关研究。两位审阅者使用预定义的结构化电子表格独立地从每个研究中提取数据。每项研究的质量由两名评论者根据纽卡斯尔-渥太华量表对Deeks等人提出的阅读队列研究进行独立评估。使用Cochrane Collaborations RevMan5.0软件进行了包括24项合格研究在内的荟萃分析。结果：二十四项确定的研究符合纳入标准和最低质量阈值。一项队列研究的荟萃分析表明，患有MRI病变的CIS确实显着增加了MS的风险（风险比[RR] = 3.71，95％置信区间[CI]，3.27-4.21，P <0.00001）。在亚组分析中（根据基线时的T2病变数量），中度MRI负荷（4-9个病变）的CIS患者发生MRI的风险高于低度MRI负荷（1-3个病变）的CIS患者（ RR = 0.66,95％CI，0.45-0.95，P <0.00001）。而在中度MRI负荷和高度MRI负荷（> 9个病灶）之间没有相关性（RR = 0.97，95％CI，0.82-1.15，P = 0.72）。同时，相较于无此类基线病变的患者，基线MRI异常的CIS患者，特别是具有幕下病变的患者，有更高的转换为MS的风险（RR = 1.37，％CI，1.09-1.73，P = 0.0008）。结论：尽管有一些限制，但这项荟萃分析为脑或脊髓MRI内是否存在MRI病变与发生MS的风险之间的联系提供了可靠的统计证据，特别是对于大样本量的研究。基线MRI异常的CIS患者，尤其是肠下肌病变，有很高的风险转为MS。但是，这种关联需要在大型且设计良好的研究中进行额外的验证。

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