Investigation of leptomeningeal enhancement in MS: A postcontrast FLAIR MRI study
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BORIS DOI
Publisher DOI
PubMed ID
25616480
Description
OBJECTIVE
To investigate possible leptomeningeal contrast enhancement using postcontrast fluid-attenuated inversion recovery (FLAIR) MRI as an additional marker of inflammation in patients with multiple sclerosis (MS).
METHODS
A cohort of 112 patients (73 women) with clinically definitive MS or a clinically isolated syndrome suggestive of CNS demyelination were included. A pathologic control group of 5 stroke patients was also examined. MRI was performed on a 3T system including FLAIR, T2-weighted, T1-weighted-contrast injection, followed by T1-weighted and FLAIR.
RESULTS
Of the 112 patients, 39 had an acute relapse at the time of MRI. In total, 96 contrast-enhancing lesions were identified on postcontrast T1-weighted images. The pathologic control group demonstrated the sensitivity of postcontrast FLAIR images demonstrating leptomeningeal enhancement in all cases. In contrast, only 1 out of 112 examined patients with MS showed a single area of abnormal leptomeningeal contrast enhancement.
CONCLUSIONS
In contrast to intraparenchymal blood-brain barrier (BBB) dysfunction that is frequently seen in patients with MS, BBB dysfunction of leptomeningeal vessels is usually not detectable in patients with early MS.
To investigate possible leptomeningeal contrast enhancement using postcontrast fluid-attenuated inversion recovery (FLAIR) MRI as an additional marker of inflammation in patients with multiple sclerosis (MS).
METHODS
A cohort of 112 patients (73 women) with clinically definitive MS or a clinically isolated syndrome suggestive of CNS demyelination were included. A pathologic control group of 5 stroke patients was also examined. MRI was performed on a 3T system including FLAIR, T2-weighted, T1-weighted-contrast injection, followed by T1-weighted and FLAIR.
RESULTS
Of the 112 patients, 39 had an acute relapse at the time of MRI. In total, 96 contrast-enhancing lesions were identified on postcontrast T1-weighted images. The pathologic control group demonstrated the sensitivity of postcontrast FLAIR images demonstrating leptomeningeal enhancement in all cases. In contrast, only 1 out of 112 examined patients with MS showed a single area of abnormal leptomeningeal contrast enhancement.
CONCLUSIONS
In contrast to intraparenchymal blood-brain barrier (BBB) dysfunction that is frequently seen in patients with MS, BBB dysfunction of leptomeningeal vessels is usually not detectable in patients with early MS.
Date of Publication
2015-02-24
Publication Type
Article
Subject(s)
Language(s)
en
Contributor(s)
Eisele, Philipp | |
Griebe, Martin | |
Szabo, Kristina | |
Wolf, Marc E | |
Alonso, Angelika | |
Hennerici, Michael G | |
Gass, Achim |
Additional Credits
Series
Neurology
Publisher
Lippincott Williams & Wilkins
ISSN
0028-3878
Access(Rights)
restricted