OBJECTIVES Aim of this study was to investigate the reliability and validity of 2D linear measures of ventricular enlargement as indirect markers of brain atrophy and possible predictors of clinical disability. METHODS In this retrospective longitudinal analysis of relapsing-remitting MS patients, brain volumes were computed at baseline and after 2 years. Frontal horn width (FHW), intercaudate distance (ICD), third ventricle width (TVW), and 4th ventricle width were obtained. Two-dimensional measures associated with brain volume at correlation analyses were entered in linear and logistic regression models testing the relationship with baseline clinical disability and 10-year confirmed disability progression (CDP), respectively. Possible cutoff values for clinically relevant atrophy were estimated via receiver operating characteristic (ROC) analyses and probed as 10-year CDP predictors using hierarchical logistic regression. RESULTS Eighty-seven patients were available (61/26 = F/M; 34.1 ± 8.5 years). Moderate negative correlations emerged between ICD and TVW and normalized brain volume (NBV; p < 0.001) and percentage brain volume change per year (PBVC/y) and FHW, ICD, and TVW annual changes (p ≤ 0.005). Baseline disability was moderately associated with NBV, ICD, and TVW (p < 0.001), while PBVC/y predicted 10-year CDP (p = 0.01). A cutoff percentage ICD change per year (PICDC/y) value of 4.38%, corresponding to - 0.91% PBVC/y, correlated with 10-year CDP (p = 0.04). These estimated cutoff values provided extra value for predicting 10-year CDP (PBVC/y: p = 0.001; PICDC/y: p = 0.03). CONCLUSIONS Two-dimensional measures of ventricular enlargement are reproducible and clinically relevant markers of brain atrophy, with ICD and its increase over time showing the best association with clinical disability. Specifically, a cutoff PICDC/y value of 4.38% could serve as a potential surrogate marker of long-term disability progression. KEY POINTS • Assessment of ventricular enlargement as a rapidly accessible indirect marker of brain atrophy may prove useful in cases in which brain volume quantification is not practicable. • Two-dimensional linear measures of ventricular enlargement represent reliable, valid, and clinically relevant markers of brain atrophy. • A cutoff annualized percentage brain volume change of - 0.91% and the corresponding annualized percentage increase of 4.38% for intercaudate distance are able to discriminate patients who will develop long-term disability progression.

中文翻译：

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2D线性心室扩大测量可能是多发性硬化症中脑萎缩和长期残疾进展的相关标志。

目的本研究旨在探讨二维线性心室增大作为脑萎缩的间接标志物和临床残疾的可能预测指标的可靠性和有效性。方法在对复发缓解型MS患者的回顾性纵向分析中，计算了基线和2年后的脑容量。获得额角宽度（FHW），尾鳍间距离（ICD），第三脑室宽度（TVW）和第四脑室宽度。在线性和逻辑回归模型中分别输入与关联分析时与脑容量相关的二维量度，分别测试与基线临床残疾和10年确诊残疾进展（CDP）的关系。临床相关萎缩的可能临界值通过接受者操作特征（ROC）分析进行估算，并使用分层Logistic回归作为10年CDP预测因子进行探讨。结果有87位患者可用（61/26 = F / M; 34.1±8.5岁）。ICD和TVW与正常脑容量（NBV; p <0.001）和每年脑容量变化百分比（PBVC / y）以及FHW，ICD和TVW年度变化（p≤0.005）之间存在中等程度的负相关。基线残疾与NBV，ICD和TVW呈中度相关（p <0.001），而PBVC / y预测为10年CDP（p = 0.01）。每年的ICD截止变化百分比（PICDC / y）值为4.38％，对应于-0.91％PBVC / y，与10年CDP相关（p = 0.04）。这些估计的临界值为预测10年CDP提供了额外的价值（PBVC / y：p = 0.001；PICDC / y：p ＝ 0.03）。结论二维心室扩大的测量是可重现的和临床相关的脑萎缩标志物，ICD及其随时间的增加显示出与临床残疾的最佳关联。具体来说，PICDC / y的截断值为4.38％可作为长期残疾进展的潜在替代指标。要点•在脑体积量化不可行的情况下，评估心室扩大是快速可行的脑萎缩间接标志物可能是有用的。•二维线性测量的心室扩大代表脑萎缩的可靠，有效和临床相关标志。•截断的年体积百分比变化为-0.91％，相应的年百分比变化为4。