BACKGROUND Differentiating multiple sclerosis (MS) from vascular risk factor (VRF)-small vessel disease (SVD) can be challenging. OBJECTIVE AND METHODS In order to determine whether or not pontine lesion location is a useful discriminator of MS and VRF-SVD, we classified pontine lesions on brain magnetic resonance imaging (MRI) as central or peripheral in 93 MS cases without VRF, 108 MS patients with VRF and 43 non-MS cases with VRF. RESULTS MS without VRF were more likely to have peripheral pons lesions (31.2%, 29/93) than non-MS with VRF (0%, 0/43) (Exp(B) = 29.8; 95% confidence interval (CI) = (1.98, 448.3); p = 0.014) but there were no significant differences regarding central pons lesions between MS without VRF (5.4%, 5/93) and non-MS with VRF patients (16.3%, 7/43) (Exp(B) = 0.89; 95% CI = (0.2, 3.94); p = 0.87). The presence of peripheral pons lesions discriminated between MS and VRF-SVD with 100% (95% CI = (91.8, 100)) specificity. The proportion of peripheral pons lesions in MS with VRF (30.5%, 33/108) was similar to that seen in MS without VRF (31.2%, 29/93, p = 0.99). Central lesions occurred in similar frequency in MS with VRF (8.3%, 9/108) and non-MS with VRF (16.3%, 7/43, p = 0.15). CONCLUSION Peripheral pons lesion location is a good discriminator of MS from vascular lesions.

中文翻译：

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脑桥病变位置在鉴别多发性硬化与血管危险因素相关小血管病中的作用

背景将多发性硬化症 (MS) 与血管危险因素 (VRF)-小血管病 (SVD) 区分开来可能具有挑战性。目的和方法为了确定脑桥病变位置是否是 MS 和 VRF-SVD 的有用鉴别器，我们将 93 例无 VRF 的 MS 病例（108 名 MS 患者）的脑核磁共振成像 (MRI) 脑桥病变分为中央或外周病变与 VRF 和 43 非 MS 案例与 VRF。结果 没有 VRF 的 MS 比有 VRF 的非 MS (0%, 0/43) 更可能有外周脑桥病变 (31.2%, 29/93)（Exp(B) = 29.8；95% 置信区间 (CI) = (1.98, 448.3); p = 0.014) 但没有 VRF 的 MS (5.4%, 5/93) 和有 VRF 的非 MS 患者 (16.3%, 7/43) (Exp( B) = 0.89；95% CI = (0.2, 3.94)；p = 0.87)。外周脑桥病变的存在以 100% (95% CI = (91.8, 100)) 的特异性区分 MS 和 VRF-SVD。伴 VRF 的 MS 中外周脑桥病变的比例 (30.5%, 33/108) 与不伴 VRF 的 MS 相似 (31.2%, 29/93, p = 0.99)。中心病变在 MS 与 VRF (8.3%, 9/108) 和非 MS 与 VRF (16.3%, 7/43, p = 0.15) 中发生的频率相似。结论 外周脑桥病变位置是 MS 与血管病变的良好鉴别器。