دورية أكاديمية
أعرض في EDS

Highly Sensitive 3-Tesla Real Inversion Recovery MRI Detects Leptomeningeal Contrast Enhancement in Chronic Active Multiple Sclerosis.

التفاصيل البيبلوغرافية
العنوان: Highly Sensitive 3-Tesla Real Inversion Recovery MRI Detects Leptomeningeal Contrast Enhancement in Chronic Active Multiple Sclerosis.
المؤلفون: Okar SV; From the Translational Neuroradiology Section, National Institute of Neurological Disorders and Stroke, National Institute of Health, Bethesda, MD, USA (S.V.O., E.S.B., M.I.G., M.A., D.S.R.); qMRI Core facility, National Institute of Neurological Disorders and Stroke, National Institute of Health, Bethesda, MD, USA (H.D., G.N.); Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA (E.S.B.); Office of Biostatistics, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA (G.N.); Department of Radiology and Radiological Sciences, Uniformed Services University of the Health Sciences, Bethesda, MD, USA (D.L.P.); Division of Neuroscience, Vita-Salute San Raffaele University and Hospital, Milan, Italy (M.A.); Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA (M.A.); Experimental Immunotherapeutics Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA (I.C.M.C.); Neuroimmunology Clinic, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA (A.F.); and Viral Immunology Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD20814, USA (S.J.)., Dieckhaus H, Beck ES, Gaitán MI, Norato G, Pham DL, Absinta M, Cortese IC, Fletcher A, Jacobson S, Nair G, Reich DS
المصدر: Investigative radiology [Invest Radiol] 2024 Mar 01; Vol. 59 (3), pp. 243-251.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 0045377 Publication Model: Print Cited Medium: Internet ISSN: 1536-0210 (Electronic) Linking ISSN: 00209996 NLM ISO Abbreviation: Invest Radiol Subsets: MEDLINE
أسماء مطبوعة: Publication: 1998- : Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: Philadelphia.
مواضيع طبية MeSH: Multiple Sclerosis*/pathology, Humans ; Female ; Adult ; Middle Aged ; Magnetic Resonance Imaging ; Meninges/diagnostic imaging ; Meninges/pathology ; Inflammation/pathology
مستخلص: Background: Leptomeningeal contrast enhancement (LME) on T2-weighted Fluid-Attenuated Inversion Recovery (T2-FLAIR) MRI is a reported marker of leptomeningeal inflammation, which is known to be associated with progression of multiple sclerosis (MS). However, this MRI approach, as typically implemented on clinical 3-tesla (T) systems, detects only a few enhancing foci in ~25% of patients and has thus been criticized as poorly sensitive.
Purpose: To compare an optimized 3D real-reconstruction inversion recovery (Real-IR) MRI sequence on a clinical 3 T scanner to T2-FLAIR for prevalence, characteristics, and clinical/radiological correlations of LME.
Materials and Methods: We obtained 3D T2-FLAIR and Real-IR scans before and after administration of standard-dose gadobutrol in 177 scans of 154 participants (98 women, 64%; mean ± SD age: 49 ± 12 years), including 124 with an MS-spectrum diagnosis, 21 with other neurological and/or inflammatory disorders, and 9 without neurological history. We calculated contrast-to-noise ratios (CNR) in 20 representative LME foci and determined association of LME with cortical lesions identified at 7 T (n = 19), paramagnetic rim lesions (PRL) at 3 T (n = 105), and clinical/demographic data.
Results: We observed focal LME in 73% of participants on Real-IR (70% in established MS, 33% in healthy volunteers, P < 0.0001), compared to 33% on T2-FLAIR (34% vs. 11%, P = 0.0002). Real-IR showed 3.7-fold more LME foci than T2-FLAIR ( P = 0.001), including all T2-FLAIR foci. LME CNR was 2.5-fold higher by Real-IR ( P < 0.0001). The major determinant of LME status was age. Although LME was not associated with cortical lesions, the number of PRL was associated with the number of LME foci on both T2-FLAIR ( P = 0.003) and Real-IR ( P = 0.0003) after adjusting for age, sex, and white matter lesion volume.
Conclusions: Real-IR a promising tool to detect, characterize, and understand the significance of LME in MS. The association between PRL and LME highlights a possible role of the leptomeninges in sustaining chronic inflammation.
(Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
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معلومات مُعتمدة: Z99 NS999999 United States ImNIH Intramural NIH HHS
تواريخ الأحداث: Date Created: 20230726 Date Completed: 20240214 Latest Revision: 20240621
رمز التحديث: 20240622
مُعرف محوري في PubMed: PMC10818009
DOI: 10.1097/RLI.0000000000001011
PMID: 37493285
قاعدة البيانات: MEDLINE
الوصف
تدمد:1536-0210
DOI:10.1097/RLI.0000000000001011