DIAGNOSTICS OF SUBCLINICAL PROGRESSION OF MULTIPLE SCLEROSIS

• Main Authors: Shamova T. M., Gordeev Ya. Ya.
• Format: Article
• Language: Belarusian
• Published: Grodno State Medical University 2019-03-01
• Series: Žurnal Grodnenskogo Gosudarstvennogo Medicinskogo Universiteta
• Subjects: multiple sclerosis; brain dystrophy; atrophic index; MRI
• Online Access: http://journal-grsmu.by/index.php/ojs/article/view/2366

Background. Multiple sclerosis (MS) refers to inflammatory degenerative diseases involving autoimmune mechanisms in the pathogenesis of the demyelinating process in the central nervous system. The atrophic process in the central nervous system is a predictor of the development of a demyelinating disease, and its initial registration will be a determining factor in the further course of MS. The main disadvantage of the existing methods for diagnosing an atrophic process is the lack of targeted software in the standard MRI kit, as well as the assessment of the state of the brain by the ratio of brain volume / liquor volume, which makes it difficult to carry out diagnostic measures at the initial stage of the demyelinating process. Purpose of the study. To present a method for diagnosing the depth of a neurodystrophic process in the brain with MS in the process of clinical and morphological monitoring due to the possibility of a sufficiently high reproduction of measurement results on a system acceptable for this pathology that does not require complicated additional software. Material and methods. The object of the study was 142 patients with primary MS and 150 healthy individuals. Diagnostics of the atrophic process was based on the results of an MRI-gram analysis and included measurements of the corpus callosum area on scans in the sagittal projection, the level of the longitudinal slit of the large brain and the area of the lateral and the 3rd ventricles on scans in the axial projection in TW2 mode. Results. An atrophic process is recorded during a primary MRI study, both in the group of individuals with significant MS and in patients with clinically isolated syndrome (CIS). Atrophic index (coefficient) is calculated by the formula Ka = SS1 / S, where S is the area of the lateral ventricles and S1 is the area of the corpus callosum. The quantitative criteria of the atrophic process of the brain in the process of MS monitoring, as well as in different age groups of healthy individuals and patients, are expressed as a percentage using the formula M max. – M Min. / T x 100 = A%. The further course of MS is accompanied by a gradual deepening of the atrophic process regardless of the presence of clinically recorded exacerbations of the disease. Conclusions. The results obtained suggest that the indicators of the atrophic process in MS are highly informative and reflect more reliably the nature of the course of the disease; they are also more correct in establishing the prognosis than the total number of demyelination foci.