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“Central vessel sign” on 3T FLAIR* MRI for the differentiation of multiple sclerosis from migraine

OBJECTIVE: The diagnosis of multiple sclerosis (MS) presently relies on radiographic assessments of imperfect specificity. Recent data using T2* methodology for the detection of the “central vessel sign” (CVS) in MS lesions suggests this novel MRI technique may distinguish MS from other disorders. O...

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Autores principales: Solomon, Andrew J., Schindler, Matthew K., Howard, Diantha B., Watts, Richard, Sati, Pascal, Nickerson, Joshua P., Reich, Daniel S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4748312/
https://www.ncbi.nlm.nih.gov/pubmed/26900578
http://dx.doi.org/10.1002/acn3.273
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author Solomon, Andrew J.
Schindler, Matthew K.
Howard, Diantha B.
Watts, Richard
Sati, Pascal
Nickerson, Joshua P.
Reich, Daniel S.
author_facet Solomon, Andrew J.
Schindler, Matthew K.
Howard, Diantha B.
Watts, Richard
Sati, Pascal
Nickerson, Joshua P.
Reich, Daniel S.
author_sort Solomon, Andrew J.
collection PubMed
description OBJECTIVE: The diagnosis of multiple sclerosis (MS) presently relies on radiographic assessments of imperfect specificity. Recent data using T2* methodology for the detection of the “central vessel sign” (CVS) in MS lesions suggests this novel MRI technique may distinguish MS from other disorders. Our aim was to determine if evaluation for CVS on 3T FLAIR* MRI differentiates MS from migraine. METHODS: Patients with MS or migraine and a prior brain MRI demonstrating at least two hyperintense lesions ≥3 mm were recruited. Exclusion criteria included any additional comorbidity known to cause brain MRI abnormalities. 3T MRI was performed in each participant with administration of gadopentetate dimeglumine, and FLAIR* images were generated in postprocessing. The total number of discrete ovoid lesions ≥3 mm were counted on FLAIR, per participant, and subsequently evaluated for presence of CVS on FLAIR*. An exploratory method evaluating for CVS in a maximum of 12 lesions per subject was also completed. RESULTS: Ten participants with MS and 10 with migraine completed the study. The median percentage (quartiles) of lesions in MS participants with CVS was 84 (79, 94) compared to 22 (15, 54) in migraine (P = 0.008). In a subanalysis by brain region, in the subcortical and deep white matter, the median percentage (quartiles) of lesions in MS participants with CVS was 88 (81, 100) compared to 19 (11, 54) in migraine (P = 0.004). This difference was not identified in juxtacortical, periventricular, or infratentorial regions. INTERPRETATION: Identification of CVS using FLAIR* on 3T MRI helps differentiate MS from migraine, particularly in the subcortical and deep white matter.
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spelling pubmed-47483122016-02-19 “Central vessel sign” on 3T FLAIR* MRI for the differentiation of multiple sclerosis from migraine Solomon, Andrew J. Schindler, Matthew K. Howard, Diantha B. Watts, Richard Sati, Pascal Nickerson, Joshua P. Reich, Daniel S. Ann Clin Transl Neurol Research Paper OBJECTIVE: The diagnosis of multiple sclerosis (MS) presently relies on radiographic assessments of imperfect specificity. Recent data using T2* methodology for the detection of the “central vessel sign” (CVS) in MS lesions suggests this novel MRI technique may distinguish MS from other disorders. Our aim was to determine if evaluation for CVS on 3T FLAIR* MRI differentiates MS from migraine. METHODS: Patients with MS or migraine and a prior brain MRI demonstrating at least two hyperintense lesions ≥3 mm were recruited. Exclusion criteria included any additional comorbidity known to cause brain MRI abnormalities. 3T MRI was performed in each participant with administration of gadopentetate dimeglumine, and FLAIR* images were generated in postprocessing. The total number of discrete ovoid lesions ≥3 mm were counted on FLAIR, per participant, and subsequently evaluated for presence of CVS on FLAIR*. An exploratory method evaluating for CVS in a maximum of 12 lesions per subject was also completed. RESULTS: Ten participants with MS and 10 with migraine completed the study. The median percentage (quartiles) of lesions in MS participants with CVS was 84 (79, 94) compared to 22 (15, 54) in migraine (P = 0.008). In a subanalysis by brain region, in the subcortical and deep white matter, the median percentage (quartiles) of lesions in MS participants with CVS was 88 (81, 100) compared to 19 (11, 54) in migraine (P = 0.004). This difference was not identified in juxtacortical, periventricular, or infratentorial regions. INTERPRETATION: Identification of CVS using FLAIR* on 3T MRI helps differentiate MS from migraine, particularly in the subcortical and deep white matter. John Wiley and Sons Inc. 2015-12-16 /pmc/articles/PMC4748312/ /pubmed/26900578 http://dx.doi.org/10.1002/acn3.273 Text en © 2015 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals, Inc on behalf of American Neurological Association. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Research Paper
Solomon, Andrew J.
Schindler, Matthew K.
Howard, Diantha B.
Watts, Richard
Sati, Pascal
Nickerson, Joshua P.
Reich, Daniel S.
“Central vessel sign” on 3T FLAIR* MRI for the differentiation of multiple sclerosis from migraine
title “Central vessel sign” on 3T FLAIR* MRI for the differentiation of multiple sclerosis from migraine
title_full “Central vessel sign” on 3T FLAIR* MRI for the differentiation of multiple sclerosis from migraine
title_fullStr “Central vessel sign” on 3T FLAIR* MRI for the differentiation of multiple sclerosis from migraine
title_full_unstemmed “Central vessel sign” on 3T FLAIR* MRI for the differentiation of multiple sclerosis from migraine
title_short “Central vessel sign” on 3T FLAIR* MRI for the differentiation of multiple sclerosis from migraine
title_sort “central vessel sign” on 3t flair* mri for the differentiation of multiple sclerosis from migraine
topic Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4748312/
https://www.ncbi.nlm.nih.gov/pubmed/26900578
http://dx.doi.org/10.1002/acn3.273
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