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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...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2015
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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. |
format | Online Article Text |
id | pubmed-4561231 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
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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