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Direct MRI detection of impending plaque development in multiple sclerosis

OBJECTIVES: To detect and localize MRI signal changes prior to the parenchymal contrast enhancement that classically defines the radiologic onset of the developing white matter lesion in multiple sclerosis (MS). METHODS: We reviewed 308 high-resolution (≤1 mm(3) voxels) MRI scans at 3T and 7T in 29...

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Autores principales: Absinta, Martina, Nair, Govind, Sati, Pascal, Cortese, Irene C.M., Filippi, Massimo, Reich, Daniel S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4561231/
https://www.ncbi.nlm.nih.gov/pubmed/26401516
http://dx.doi.org/10.1212/NXI.0000000000000145
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author Absinta, Martina
Nair, Govind
Sati, Pascal
Cortese, Irene C.M.
Filippi, Massimo
Reich, Daniel S.
author_facet Absinta, Martina
Nair, Govind
Sati, Pascal
Cortese, Irene C.M.
Filippi, Massimo
Reich, Daniel S.
author_sort Absinta, Martina
collection PubMed
description OBJECTIVES: To detect and localize MRI signal changes prior to the parenchymal contrast enhancement that classically defines the radiologic onset of the developing white matter lesion in multiple sclerosis (MS). METHODS: We reviewed 308 high-resolution (≤1 mm(3) voxels) MRI scans at 3T and 7T in 29 patients with active MS. The presence of pre-parenchymal enhancement abnormalities before the appearance of parenchymal enhancement was evaluated in all available scans. RESULTS: Pre-enhancement signal changes were noted in 26 of 162 enhancing lesions (16%) as linear enhancement of the central vein and/or perivenular hyperintense signal on T2 fluid-attenuated inversion recovery or T2* images. They occur up to 2 months before focal enhancement within the parenchyma in 10% of cases. CONCLUSIONS: In some lesions, the abrupt opening of the blood-brain barrier, detected by contrast enhancement on MRI, can have directly visible antecedent MRI changes centered on the central vein. We propose that these findings might be the basis for prior reports of subtle pre-parenchymal enhancement changes in quantitative MRI indices. In line with the venulocentric model of lesion development, our findings are consistent with the centrality of early perivenular events in lesion formation in vivo.
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spelling pubmed-45612312015-09-23 Direct MRI detection of impending plaque development in multiple sclerosis Absinta, Martina Nair, Govind Sati, Pascal Cortese, Irene C.M. Filippi, Massimo Reich, Daniel S. Neurol Neuroimmunol Neuroinflamm Article OBJECTIVES: To detect and localize MRI signal changes prior to the parenchymal contrast enhancement that classically defines the radiologic onset of the developing white matter lesion in multiple sclerosis (MS). METHODS: We reviewed 308 high-resolution (≤1 mm(3) voxels) MRI scans at 3T and 7T in 29 patients with active MS. The presence of pre-parenchymal enhancement abnormalities before the appearance of parenchymal enhancement was evaluated in all available scans. RESULTS: Pre-enhancement signal changes were noted in 26 of 162 enhancing lesions (16%) as linear enhancement of the central vein and/or perivenular hyperintense signal on T2 fluid-attenuated inversion recovery or T2* images. They occur up to 2 months before focal enhancement within the parenchyma in 10% of cases. CONCLUSIONS: In some lesions, the abrupt opening of the blood-brain barrier, detected by contrast enhancement on MRI, can have directly visible antecedent MRI changes centered on the central vein. We propose that these findings might be the basis for prior reports of subtle pre-parenchymal enhancement changes in quantitative MRI indices. In line with the venulocentric model of lesion development, our findings are consistent with the centrality of early perivenular events in lesion formation in vivo. Lippincott Williams & Wilkins 2015-09-03 /pmc/articles/PMC4561231/ /pubmed/26401516 http://dx.doi.org/10.1212/NXI.0000000000000145 Text en © 2015 American Academy of Neurology This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially.
spellingShingle Article
Absinta, Martina
Nair, Govind
Sati, Pascal
Cortese, Irene C.M.
Filippi, Massimo
Reich, Daniel S.
Direct MRI detection of impending plaque development in multiple sclerosis
title Direct MRI detection of impending plaque development in multiple sclerosis
title_full Direct MRI detection of impending plaque development in multiple sclerosis
title_fullStr Direct MRI detection of impending plaque development in multiple sclerosis
title_full_unstemmed Direct MRI detection of impending plaque development in multiple sclerosis
title_short Direct MRI detection of impending plaque development in multiple sclerosis
title_sort direct mri detection of impending plaque development in multiple sclerosis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4561231/
https://www.ncbi.nlm.nih.gov/pubmed/26401516
http://dx.doi.org/10.1212/NXI.0000000000000145
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