Diagnostic and Prognostic Value of Conventional Brain MRI in the Clinical Work-Up of Patients with Amyotrophic Lateral Sclerosis
Clinical signs of upper motor neuron (UMN) involvement are important in the diagnosis of amyotrophic lateral sclerosis (ALS) though are often difficult to analyze. Many studies using both qualitative and quantitative evaluations have reported abnormal Magnetic Resonance Imaging (MRI) findings at the...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/8/2538 |
| _version_ | 1797560018305810432 |
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| author | Giovanni Rizzo Anna Federica Marliani Stella Battaglia Luca Albini Riccioli Silvia De Pasqua Veria Vacchiano Rossella Infante Patrizia Avoni Vincenzo Donadio Massimiliano Passaretti Ilaria Bartolomei Fabrizio Salvi Rocco Liguori on behalf of the BoReALS group |
| author_facet | Giovanni Rizzo Anna Federica Marliani Stella Battaglia Luca Albini Riccioli Silvia De Pasqua Veria Vacchiano Rossella Infante Patrizia Avoni Vincenzo Donadio Massimiliano Passaretti Ilaria Bartolomei Fabrizio Salvi Rocco Liguori on behalf of the BoReALS group |
| author_sort | Giovanni Rizzo |
| collection | DOAJ |
| description | Clinical signs of upper motor neuron (UMN) involvement are important in the diagnosis of amyotrophic lateral sclerosis (ALS) though are often difficult to analyze. Many studies using both qualitative and quantitative evaluations have reported abnormal Magnetic Resonance Imaging (MRI) findings at the level of the pyramidal pathway in patients with ALS. Although the most interesting results were obtained by quantitative studies using advanced MR techniques, the qualitative evaluation of MRI images remains the most-used in clinical practice. We evaluated the diagnostic and prognostic contribution of conventional 3T-MRI in the clinical work-up of ALS patients. Two neuroradiologists retrospectively assessed 3T-MRI data of 93 ALS patients and 89 controls. The features of interest were corticospinal tract (CST) T2/FLAIR hyperintensity, motor cortex (MC) T2*/SWI hypointensity, and selective MC atrophy. All MRI features were significantly more prevalent in ALS patients than in controls. The simultaneous presence of CST FLAIR hyperintensity and MC SWI hypointensity was associated with the highest diagnostic accuracy (sensitivity: 70%; specificity: 81%; positive predictive value, PPV: 90%; negative predictive value, NPV: 51%; accuracy: 73%) and a shorter survival (HR: 6.56, <i>p</i> = 0.002). Conventional 3T-MRI can be a feasible tool to detect specific qualitative changes based on UMN involvement and to support clinical diagnosis of ALS. Importantly, CST FLAIR hyperintensity and MC SWI hypointensity are predictors of shorter survival in ALS patients. |
| first_indexed | 2024-03-10T17:53:29Z |
| format | Article |
| id | doaj.art-0e528c7be8ca47fdb39c0a092b345c0e |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T17:53:29Z |
| publishDate | 2020-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-0e528c7be8ca47fdb39c0a092b345c0e2023-11-20T09:15:05ZengMDPI AGJournal of Clinical Medicine2077-03832020-08-0198253810.3390/jcm9082538Diagnostic and Prognostic Value of Conventional Brain MRI in the Clinical Work-Up of Patients with Amyotrophic Lateral SclerosisGiovanni Rizzo0Anna Federica Marliani1Stella Battaglia2Luca Albini Riccioli3Silvia De Pasqua4Veria Vacchiano5Rossella Infante6Patrizia Avoni7Vincenzo Donadio8Massimiliano Passaretti9Ilaria Bartolomei10Fabrizio Salvi11Rocco Liguori12on behalf of the BoReALS groupDepartment of Biomedical and Neuromotor Sciences, University of Bologna, Via Altura 3, 40139 Bologna, ItalyIRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 3, 40139 Bologna, ItalyIRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 3, 40139 Bologna, ItalyIRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 3, 40139 Bologna, ItalyDepartment of Biomedical and Neuromotor Sciences, University of Bologna, Via Altura 3, 40139 Bologna, ItalyDepartment of Biomedical and Neuromotor Sciences, University of Bologna, Via Altura 3, 40139 Bologna, ItalyDepartment of Biomedical and Neuromotor Sciences, University of Bologna, Via Altura 3, 40139 Bologna, ItalyDepartment of Biomedical and Neuromotor Sciences, University of Bologna, Via Altura 3, 40139 Bologna, ItalyIRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 3, 40139 Bologna, ItalyDepartment of Biomedical and Neuromotor Sciences, University of Bologna, Via Altura 3, 40139 Bologna, ItalyIRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 3, 40139 Bologna, ItalyIRCCS Istituto delle Scienze Neurologiche di Bologna, Via Altura 3, 40139 Bologna, ItalyDepartment of Biomedical and Neuromotor Sciences, University of Bologna, Via Altura 3, 40139 Bologna, ItalyClinical signs of upper motor neuron (UMN) involvement are important in the diagnosis of amyotrophic lateral sclerosis (ALS) though are often difficult to analyze. Many studies using both qualitative and quantitative evaluations have reported abnormal Magnetic Resonance Imaging (MRI) findings at the level of the pyramidal pathway in patients with ALS. Although the most interesting results were obtained by quantitative studies using advanced MR techniques, the qualitative evaluation of MRI images remains the most-used in clinical practice. We evaluated the diagnostic and prognostic contribution of conventional 3T-MRI in the clinical work-up of ALS patients. Two neuroradiologists retrospectively assessed 3T-MRI data of 93 ALS patients and 89 controls. The features of interest were corticospinal tract (CST) T2/FLAIR hyperintensity, motor cortex (MC) T2*/SWI hypointensity, and selective MC atrophy. All MRI features were significantly more prevalent in ALS patients than in controls. The simultaneous presence of CST FLAIR hyperintensity and MC SWI hypointensity was associated with the highest diagnostic accuracy (sensitivity: 70%; specificity: 81%; positive predictive value, PPV: 90%; negative predictive value, NPV: 51%; accuracy: 73%) and a shorter survival (HR: 6.56, <i>p</i> = 0.002). Conventional 3T-MRI can be a feasible tool to detect specific qualitative changes based on UMN involvement and to support clinical diagnosis of ALS. Importantly, CST FLAIR hyperintensity and MC SWI hypointensity are predictors of shorter survival in ALS patients.https://www.mdpi.com/2077-0383/9/8/2538ALSMRIMNDcorticospinal tractmotor cortexSWI |
| spellingShingle | Giovanni Rizzo Anna Federica Marliani Stella Battaglia Luca Albini Riccioli Silvia De Pasqua Veria Vacchiano Rossella Infante Patrizia Avoni Vincenzo Donadio Massimiliano Passaretti Ilaria Bartolomei Fabrizio Salvi Rocco Liguori on behalf of the BoReALS group Diagnostic and Prognostic Value of Conventional Brain MRI in the Clinical Work-Up of Patients with Amyotrophic Lateral Sclerosis Journal of Clinical Medicine ALS MRI MND corticospinal tract motor cortex SWI |
| title | Diagnostic and Prognostic Value of Conventional Brain MRI in the Clinical Work-Up of Patients with Amyotrophic Lateral Sclerosis |
| title_full | Diagnostic and Prognostic Value of Conventional Brain MRI in the Clinical Work-Up of Patients with Amyotrophic Lateral Sclerosis |
| title_fullStr | Diagnostic and Prognostic Value of Conventional Brain MRI in the Clinical Work-Up of Patients with Amyotrophic Lateral Sclerosis |
| title_full_unstemmed | Diagnostic and Prognostic Value of Conventional Brain MRI in the Clinical Work-Up of Patients with Amyotrophic Lateral Sclerosis |
| title_short | Diagnostic and Prognostic Value of Conventional Brain MRI in the Clinical Work-Up of Patients with Amyotrophic Lateral Sclerosis |
| title_sort | diagnostic and prognostic value of conventional brain mri in the clinical work up of patients with amyotrophic lateral sclerosis |
| topic | ALS MRI MND corticospinal tract motor cortex SWI |
| url | https://www.mdpi.com/2077-0383/9/8/2538 |
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