Journal Article Ppublish
PubMed: 40785937 DOI: 10.21037/qims-2025-82
In vivo detection of oxidative stress and iron deposition by proton exchange rate ( ) MRI and quantitative susceptibility mapping for differentiating multiple sclerosis from cerebral small vessel diseases.
Quant Imaging Med Surg 15(8):6933-6947
Authors: Mingjia Hou, Huiting Liao, Han Li, Zimeng Cai, Songran Zhong, Weiwei Chen, Kejia Cai
Affiliations
- Department of Radiology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China.
- Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.
- Department of Radiology, Guangdong Provincial People's Hospital, Guangzhou, China. Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, Guangdong Provincial People's Hospital, Guangzhou, China.
- Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China.
- Department of Radiology, University of Illinois Chicago, Chicago, IL, USA.
- Department of Biomedical Engineering, University of Illinois Chicago, Chicago, IL, USA.
Abstract
Background
The differential diagnosis of multiple sclerosis (MS) and cerebral small vessel disease (SVD) is challenging on conventional sequences. This study aimed to explore the utility of in vivo proton exchange rate ( ) magnetic resonance imaging (MRI) and quantitative susceptibility mapping (QSM) in distinguishing MS from SVD.
Methods
This Institutional Review Board (IRB)-approved retrospective study included 40 relapsing-remitting MS patients, 23 SVD patients, and 25 healthy controls (HCs), who underwent QSM and MRI. The susceptibility and values were compared among MS white matter lesions (MS-WMLs), lacunes, and white matter hyperintensities (WMHs) of SVD, with receiver operating characteristic (ROC) analysis performed.
Results
Susceptibility increase (ΔSusceptibility) and elevation (Δ ) were both higher in MS-WMLs than they were in WMHs (31.60±21.76 vs. 4.96±9.30 ppb, P<0.001; 147.01±100.34 vs. 58.37±43.81 s -1, P<0.001). The values were higher in normal appearing white matter of MS and SVD than in normal white matter (NWM) of HCs (650.74±42.84 or 645.00±23.62 vs. 608.99±23.77 s -1, P<0.001). No WMHs presented ring hyperintensity on QSM. The percentage of ring QSM hyperintensity of lacunes was larger than that of MS-WMLs. The rings of MS-WMLs were more regular and evenly thickened than those of lacunes. A significantly positive correlation between elevation and susceptibility increase was noticed only in MS. Compared with women, men showed slightly higher Δ of WMLs and NAWM in MS, WMHs, and lacunes in SVD and higher ΔSusceptibility of MS-WMLs. The accuracy for differentiating MS-WMLs from WMHs and lacunes with Δ and ΔSusceptibility together [area under the curve (AUC) =0.910, 95% confidence interval (CI): 0.875-0.938] was higher than that when using them alone.
Conclusions
The in vivo visualization and quantification of oxidative stress and iron deposition via MRI and QSM are potential biomarkers to promote the early differential diagnosis of MS and SVD.
MeSH
White Matter, Diagnosis, Differential, Sclerosis, Multiple Sclerosis, Ethics Committees, Research, Stress, Physiological, Oxidative Stress, Diagnosis, Cerebral Small Vessel Diseases, Quantitative Susceptibility Mapping