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Consensus Recommendations of the Multiple Sclerosis Study Group and the Portuguese Neuroradiological Society for the Use of Magnetic Resonance Imaging in Multiple Sclerosis in Clinical Practice: Part 2.
多发性硬化症研究组和葡萄牙神经放射学会对多发性硬化症在临床实践中使用磁共振成像的共识建议: 第2部分。
- 影响因子：25.02
- DOI：10.20344/amp.11532
- 作者列表："Pereira DJ","Abreu P","Reis AM","Seixas D","Carreiro I","Cravo I","Graça J","Freitas PM","Brito O","Silva S","Vale J","Vilela P
- 发表时间：2020-01-03
Abstract
INTRODUCTION:Magnetic resonance imaging is recognized as the most important diagnostic test in the diagnosis of multiple sclerosis, differential diagnosis and evaluation of progression/therapeutic response. However, to make optimal use of magnetic resonance imaging in multiple sclerosis, the use of a standard, reproducible and comparable imaging protocol is of uttermost importance. In this context, the Portuguese Society of Neuroradiology and the Group of Studies of Multiple Sclerosis, after a joint discussion, appointed a committee of experts to create recommendations adapted to the national reality on the use of magnetic resonance imaging in multiple sclerosis. This document represents the second part of the first Portuguese consensus recommendations on the use of magnetic resonance imaging in multiple sclerosis in clinical practice. MATERIAL AND METHODS:The Portuguese Society of Neuroradiology and the Group of Studies of Multiple Sclerosis, after discussing the topic in national meetings and after a working group meeting held in Figueira da Foz, May 2017, appointed a committee of experts that have developed several standard protocols on the use of magnetic resonance imaging on multiple sclerosis by consensus. The document obtained was based on the best scientific evidence and expert opinion. Portuguese multiple sclerosis consultants and departments of neuroradiology scrutinized and reviewed the consensus paper; comments and suggestions were considered. Standardized strategies of magnetic resonance imaging referral in clinical practice for diagnosis and follow-up of multiple sclerosis were published in the first part of this paper. RESULTS:We provide magnetic resonance imaging acquisition protocols regarding multiple sclerosis diagnostic and monitoring and the information to be included in the report for application across Portuguese healthcare institutions. CONCLUSION:We hope that these first Portuguese magnetic resonance imaging guidelines will contribute to optimize multiple sclerosis management and improve patient care in Portugal. :Introdução: A ressonância magnética é considerada o exame complementar mais importante para o diagnóstico de esclerose múltipla, seus diagnósticos diferenciais e avaliação da sua progressão/resposta terapêutica. No entanto, para um uso ótimo desta ferramenta na esclerose múltipla, é essencial a aplicação de um protocolo de imagem padronizado, reprodutível e comparável. Neste contexto, o Grupo de Estudos de Esclerose Múltipla e a Sociedade Portuguesa de Neurorradiologia, após discussão conjunta, designaram um comité de peritos para a criação de recomendações adaptadas à realidade nacional sobre a utilização da ressonância magnética na esclerose múltipla. Este documento corresponde à segunda parte das primeiras recomendações de consenso portuguesas sobre a utilização da ressonância magnética na esclerose múltipla na prática clínica. Material e Métodos: O Grupo de Estudos de Esclerose Múltipla e a Sociedade Portuguesa de Neurorradiologia após discussão do tema em reuniões de âmbito nacional e de uma reunião do grupo de trabalho que teve lugar na Figueira da Foz em maio de 2017, designaram um comité de peritos que elaboraram por método de consenso protocolos padronizados sobre o uso da ressonância magnética na esclerose múltipla. O documento teve como base a melhor evidência científica e a opinião dos peritos. Posteriormente, o documento foi enviado para escrutínio à maioria dos responsáveis de consulta de esclerose múltipla e dos departamentos de neurorradiologia; tendo sido considerados os seus comentários e sugestões. As estratégias padronizadas de referenciação imagiológica na prática clínica para o diagnóstico e seguimento da esclerose múltipla foram publicadas na primeira parte deste artigo. Resultados: Neste artigo são propostos os protocolos de aquisição de ressonância magnética adequados para o diagnóstico e monitorização da esclerose múltipla, bem como a informação a constar do relatório imagiológico, tendo em vista a sua aplicação nas várias instituições de saúde portuguesas. Conclusão: Os autores esperam que estas primeiras orientações portuguesas sobre a utilização da ressonância magnética na esclerose múltipla na prática clínica contribuam para otimizar a gestão desta patologia e melhorar o tratamento destes doentes em Portugal.
摘要
引言: 磁共振成像被认为是诊断多发性硬化症、鉴别诊断疾病和评估进展/治疗反应的最重要的诊断测试。然而，为了在多发性硬化中最佳利用磁共振成像，使用标准的、可重复的和可比较的成像方案是最重要的。在这种情况下，葡萄牙神经放射学会和多发性硬化症研究小组在联合讨论后，任命了一个专家委员会，以制定适合国家现实的关于多发性硬化症磁共振成像使用的建议。该文件代表了第一个葡萄牙共识建议的第二部分，即在临床实践中使用多发性硬化症的磁共振成像。 材料和方法: 葡萄牙神经放射学会和多发性硬化症研究小组，在全国会议上讨论该主题后，在Figueira da Foz举行的工作组会议后，2017年5月，任命了一个专家委员会，该委员会以协商一致方式制定了关于多发性硬化症磁共振成像使用的若干标准方案。获得的文件是基于最好的科学证据和专家意见。葡萄牙多发性硬化症顾问和神经放射学部门仔细审查并审查了共识文件; 考虑了意见和建议。在多发性硬化的诊断和随访的临床实践中，磁共振成像转诊的标准化策略发表在本文的第一部分。 结果: 我们提供了关于多发性硬化症诊断和监测的磁共振成像采集协议，以及报告中包含的信息，供葡萄牙医疗机构申请。 结论: 我们希望这些第一个葡萄牙磁共振成像指南将有助于优化多发性硬化症管理和改善葡萄牙的患者护理。 : Introdução: ressonância magnética é considerada o exame complementar mais atenci ó n para o diagnóstico de esclerose múltipla，seus diagnósticos diferenciais e avaliação da制止危及海上航行安全非法行为progressão/resposta terapêutica.没有entanto，para um uso ó timo desta ferramenta na esclerose m ú ltipla，é essencial a aplica ç ã oumdeimagenempadronizado，reprodut í velecompar á vel。Neste contexto，o Grupo de escilludosum ú ltipla e a Sociedade portugu esa de Neurorradiologia，ap ó s discussao conjunta，designaram comit é depara para cria ç ã oderecomenda ú lapadas à realidade naci sobre utila ç ã oda sonrescia magni é spla é clerna。Estdocumento对应segunda parte das primeiras recomenda ç es es de consenso portugu esas sobre a utiliza ç ã oda resson â ncia ma é tacna escerose m ú ltiplanupra á ticcl í nica。材料e m é todos: O Grupo de escerudos de escerose m ú ltipla e a Sociedade Portuguesa de neuroorradiologasia ap ó s discussion s ã otema em reunies de â mbito nacional e de uma reunio do grupo de trabalho que teve lugar na Figueira da Foz em maio de 2017，designaram um comit é de perdos que exfore aram por m é todo de consenso protocolos padronizados sobre o uso da resson â ncia magna é tica na escerlose m ú ltipla.O documento teve como base a melhor evid ê ncia cient í fica e a opinion ã O dos perdos.后验，o文档foi enviado para escrut í nio à maioria dos respons á veisdeconsulta de escerlose m ú ltipla e dos departamentos de neurorradiologiia; tendo sido academados seuscoment á rios e sugest ões.作为estra é giaspadronizadasdereferencia ç ã oimagiol ó gicacnapra á ticaccl í nicaparodiagn ó sticoeseguimentodescerosym ú ltipla foram publicadasna primeira parte deste artigo。结果Conclus ã o: Os autores esperamqueestasprimeirasorienta ç es es portutesassobreasabliza ç ã odaressonicamma é tacnaescerosym ú ltiplapnapr á ticclinica contribumageotimizaragegestã opatologie melhoraro tratamentodestes dotees doentees doentees葡萄牙。
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DOI：10.1080/09273948.2019.1597896
作者列表：["Apivatthakakul A","Kunavisarut P","Rothova A","Pathanapitoon K"]
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METHODS::Comprehensive reviews of the clinical characteristics and pathogenesis of Aicardi-Goutières syndrome (AGS), particularly its contextualization within a putative type I interferonopathy framework, already exist. However, recent reports of attempts at treatment suggest that an assessment of the field from a therapeutic perspective is warranted at this time. Here, we briefly summarize the neurological phenotypes associated with mutations in the seven genes so far associated with AGS, rehearse current knowledge of the pathology as it relates to possible treatment approaches, critically appraise the potential utility of therapies, and discuss the challenges in assessing clinical efficacy. WHAT THIS PAPER ADDS: Progress in understanding AGS disease pathogenesis has led to the first attempts at targeted treatment. Further rational therapies are expected to become available in the short- to medium-term.
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神经系统自身免疫性疾病是以自身免疫细胞、免疫分子等攻击神经系统为主要致病机制的自身免疫性疾病。在免疫反应中，作用于神经系统自身抗原的致病抗体统称为神经系统自身抗体。
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