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MRI predictors for the conversion from contrast-enhancing to iron rim multiple sclerosis lesions

BACKGROUND: In multiple sclerosis (MS), iron rim lesions (IRLs) are characterized by progressive tissue matrix damage. Therefore, early identification could represent an interesting target for therapeutic intervention to minimize evolving tissue damage. The aim of this study was to identify magnetic...

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Autores principales: Wenzel, Nicolas, Wittayer, Matthias, Weber, Claudia E., Schirmer, Lucas, Platten, Michael, Gass, Achim, Eisele, Philipp
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9293822/
https://www.ncbi.nlm.nih.gov/pubmed/35332392
http://dx.doi.org/10.1007/s00415-022-11082-2
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author Wenzel, Nicolas
Wittayer, Matthias
Weber, Claudia E.
Schirmer, Lucas
Platten, Michael
Gass, Achim
Eisele, Philipp
author_facet Wenzel, Nicolas
Wittayer, Matthias
Weber, Claudia E.
Schirmer, Lucas
Platten, Michael
Gass, Achim
Eisele, Philipp
author_sort Wenzel, Nicolas
collection PubMed
description BACKGROUND: In multiple sclerosis (MS), iron rim lesions (IRLs) are characterized by progressive tissue matrix damage. Therefore, early identification could represent an interesting target for therapeutic intervention to minimize evolving tissue damage. The aim of this study was to identify magnetic resonance imaging (MRI) parameters predicting the conversion from contrast-enhancing to IRLs. METHODS: We retrospective identified MS patients scanned on the same 3 T MRI system presenting at least one supratentorial contrast-enhancing lesion (CEL) and a second MRI including susceptibility-weighted images after at least 3 months. On baseline MRI, pattern of contrast-enhancement was categorized as “nodular” or “ring-like”, apparent diffusion coefficient (ADC) maps were assessed for the presence of a peripheral hypointense rim. Lesion localization, quantitative volumes (ADC, lesion volume) and the presence of a central vein were assessed. RESULTS: Eighty-nine acute contrast-enhancing lesions in 54 MS patients were included. On follow-up, 16/89 (18%) initially CELs converted into IRLs. CELs that converted into IRLs were larger and demonstrated significantly more often a ring-like contrast-enhancement pattern and a peripheral hypointense rim on ADC maps. Logistic regression model including the covariables pattern of contrast-enhancement and presence of a hypointense rim on ADC maps showed the best predictive performance (area under the curve = 0.932). DISCUSSION: The combination of a ring-like contrast-enhancement pattern and a peripheral hypointense rim on ADC maps has the ability to predict the evolution from acute to IRLs. This could be of prognostic value and become a target for early therapeutic intervention to minimize the associated tissue damage.
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spelling pubmed-92938222022-07-20 MRI predictors for the conversion from contrast-enhancing to iron rim multiple sclerosis lesions Wenzel, Nicolas Wittayer, Matthias Weber, Claudia E. Schirmer, Lucas Platten, Michael Gass, Achim Eisele, Philipp J Neurol Original Communication BACKGROUND: In multiple sclerosis (MS), iron rim lesions (IRLs) are characterized by progressive tissue matrix damage. Therefore, early identification could represent an interesting target for therapeutic intervention to minimize evolving tissue damage. The aim of this study was to identify magnetic resonance imaging (MRI) parameters predicting the conversion from contrast-enhancing to IRLs. METHODS: We retrospective identified MS patients scanned on the same 3 T MRI system presenting at least one supratentorial contrast-enhancing lesion (CEL) and a second MRI including susceptibility-weighted images after at least 3 months. On baseline MRI, pattern of contrast-enhancement was categorized as “nodular” or “ring-like”, apparent diffusion coefficient (ADC) maps were assessed for the presence of a peripheral hypointense rim. Lesion localization, quantitative volumes (ADC, lesion volume) and the presence of a central vein were assessed. RESULTS: Eighty-nine acute contrast-enhancing lesions in 54 MS patients were included. On follow-up, 16/89 (18%) initially CELs converted into IRLs. CELs that converted into IRLs were larger and demonstrated significantly more often a ring-like contrast-enhancement pattern and a peripheral hypointense rim on ADC maps. Logistic regression model including the covariables pattern of contrast-enhancement and presence of a hypointense rim on ADC maps showed the best predictive performance (area under the curve = 0.932). DISCUSSION: The combination of a ring-like contrast-enhancement pattern and a peripheral hypointense rim on ADC maps has the ability to predict the evolution from acute to IRLs. This could be of prognostic value and become a target for early therapeutic intervention to minimize the associated tissue damage. Springer Berlin Heidelberg 2022-03-25 2022 /pmc/articles/PMC9293822/ /pubmed/35332392 http://dx.doi.org/10.1007/s00415-022-11082-2 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Communication
Wenzel, Nicolas
Wittayer, Matthias
Weber, Claudia E.
Schirmer, Lucas
Platten, Michael
Gass, Achim
Eisele, Philipp
MRI predictors for the conversion from contrast-enhancing to iron rim multiple sclerosis lesions
title MRI predictors for the conversion from contrast-enhancing to iron rim multiple sclerosis lesions
title_full MRI predictors for the conversion from contrast-enhancing to iron rim multiple sclerosis lesions
title_fullStr MRI predictors for the conversion from contrast-enhancing to iron rim multiple sclerosis lesions
title_full_unstemmed MRI predictors for the conversion from contrast-enhancing to iron rim multiple sclerosis lesions
title_short MRI predictors for the conversion from contrast-enhancing to iron rim multiple sclerosis lesions
title_sort mri predictors for the conversion from contrast-enhancing to iron rim multiple sclerosis lesions
topic Original Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9293822/
https://www.ncbi.nlm.nih.gov/pubmed/35332392
http://dx.doi.org/10.1007/s00415-022-11082-2
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