The value of chemical fat saturation pulse added to T1-weighted spin-echo sequence in evaluating gadolinium-enhancing brain lesions in multiple sclerosis

To estimate the relative sensitivity of MR examination for brain lesions in multiple sclerosis at 1.0 Tesla (T) and 3.0 T using identical acquisition conditions. 54 patients with multiple sclerosis were examined both at 1.0T (Siemens Impact Expert) and 3.0T (Philips Intera) using T1-weighted spin echo (T1W-SE) with and without gadolinium contrast injections, T2W SE and fluid attenuated inversion recovery (FLAIR) imaging. Images were examined independently by three experienced neuroradiologists using focal lesion counting. 3.0T scans compared with 1.0T scans demonstrate a 27.3%, increase in the number of detected contrast enhanced lesions and an 22.7% increase in the number of detected lesions on FLAIR MR tomograms. High field 3.0T MR imaging demonstrates better sensitivity in the detection of focal brain lesions in multiple sclerosis. This improvement is more apparent in contrast enhanced lesion detection and less noticeable in FLAIR detected lesions.

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Estimation of the macromolecular proton fraction and bound pool T2 in multiple sclerosis

Multiple Sclerosis Journal ◽

10.1191/1352458504ms1105oa ◽

2004 ◽

Vol 10 (6) ◽

pp. 607-613 ◽

Cited By ~ 37

Author(s):

Davies GR ◽

Tozer DJ ◽

Cercignani M ◽

Ramani A ◽

Dalton CM ◽

...

Keyword(s):

Multiple Sclerosis ◽

Spin Echo ◽

Magnetization Transfer ◽

Time Estimation ◽

Fast Spin Echo ◽

Proton Density ◽

Normal Appearing White Matter ◽

Spin Echo Sequence ◽

Fast Spin Echo Sequence ◽

Weighted Sequences

This study used a model for magnetization transfer (MT) to estimate two underlying parameters: the macromolecular proton fraction (f) and the bound pool T2 (T2b) in patients with multiple sclerosis (MS). Sixty patients with clinically definite MS and 27 healthy controls were imaged using: (1) a dual echo fast spin echo sequence, (2) a MT sequence (with ten MT power and offset frequency combinations) and (3) proton density and T1 weighted sequences (for T1 relaxation time estimation). Fourteen normal-appearing white matter (NAWM) regions of interest (ROI) and six normal-appearing gray matter (NAGM) ROIs were outlined in all subjects. Lesions were also contoured in subjects affected by MS. The model was fitted to the data leading to estimates of T2b and f. Results showed that T2b was increased in lesions whereas f was reduced. In NAWM, f was decreased while T2b was only increased in secondary progressive MS. NAWM f correlated modestly with disability. Further studies are needed to investigate the pathological basis of the abnormalities observed.

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Time-dependency in brain lesion enhancement with gadodiamide injection

Acta Radiologica ◽

10.1080/02841859709171236 ◽

1997 ◽

Vol 38 (1) ◽

pp. 19-24 ◽

Cited By ~ 28

Author(s):

P. Åkeson ◽

C.-H. Nordström ◽

S. Holtås

Keyword(s):

Time Window ◽

Spin Echo ◽

Brain Lesion ◽

Brain Lesions ◽

Time Dependency ◽

Contrast Injection ◽

Effective Time ◽

Peak Enhancement ◽

Spin Echo Sequence ◽

Major Increase

Purpose: To determine the effective time window for MR imaging of tumors with blood-brain barrier (BBB) damage after injection of Gd-containing contrast media. Material and Methods: Eleven patients with 15 brain lesions (metastasis, glioma, abscess) were studied with a T1-weighted spin-echo sequence repeated over periods of up to 43 min after contrast injection. A quotient was calculated between the signals in the lesion and in the gray matter, and plotted against time. Results: All lesions reached 70% of the maximum RATIO within 3.5 min. After 25 min 12 out of 15 lesions showed persistent enhancement within 15% of the maximal RATIO. Conclusion: The peak enhancement of BBB damage occurs around 3.5 min after injection. The effect does not change during the next 25 min. Scanning should not be started until 2–5 min after injection of the contrast medium, and there is no advantage in waiting longer as no major increase (or decline) of contrast can be expected.

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Multi-Contrast, Isotropic, Single-Slab 3D MR Imaging in Multiple Sclerosis

The Neuroradiology Journal ◽

10.1177/19714009090220s108 ◽

2009 ◽

Vol 22 (1_suppl) ◽

pp. 33-42

Author(s):

Bastiaan Moraal ◽

Stefan D. Roosendaal ◽

Petra J. W. Pouwels ◽

Hugo Vrenken ◽

Ronald A. van Schijndel ◽

...

Keyword(s):

Multiple Sclerosis ◽

Spin Echo ◽

Brain Lesions ◽

Lesion Detection ◽

Inversion Recovery ◽

Rapid Acquisition ◽

Fluid Attenuated Inversion Recovery ◽

Student’S T ◽

3D Sequences ◽

3D Flair

To describe signal and contrast properties of an isotropic, single-slab 3D dataset [double inversion-recovery (DIR), fluid-attenuated inversion recovery (FLAIR), T2, and T1-weighted magnetization prepared rapid acquisition gradient-echo (MPRAGE)] and to evaluate its performance in detecting multiple sclerosis (MS) brain lesions compared to 2D T2-weighted spin-echo (T2SE). All single-slab 3D sequences and 2D-T2SE were acquired in 16 MS patients and 9 age-matched healthy controls. Lesions were scored independently by two raters and characterized anatomically. Two-tailed Bonferroni-corrected Student's t-tests were used to detect differences in lesion detection between the various sequences per anatomical area after log-transformation. In general, signal and contrast properties of the 3D sequences enabled improved detection of MS brain lesions compared to 2D-T2SE. Specifically, 3D-DIR showed the highest detection of intracortical and mixed WM-GM lesions, whereas 3D-FLAIR showed the highest total number of WM lesions. Both 3D-DIR and 3D-FLAIR showed the highest number of infratentorial lesions. 3D-T2 and 3D-MPRAGE did not improve lesion detection compared to 2D-T2SE. Multi-contrast, isotropic, single-slab 3D MRI allowed an improved detection of both GM and WM lesions compared to 2D-T2SE. A selection of single-slab 3D contrasts, for example, 3D-FLAIR and 3D-DIR, could replace 2D sequences in the radiological practice.

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T1 inversion recovery pulse sequence: could it replace T1 spin echo sequence in neuroimaging by improving tissue contrast?

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-019-0028-5 ◽

2019 ◽

Vol 50 (1) ◽

Author(s):

Mohamed Shawky ◽

Rehab Habib ◽

Ahmed Elsawaf

Keyword(s):

Multiple Sclerosis ◽

Contrast Media ◽

Pulse Sequence ◽

Spin Echo ◽

Contrast Ratio ◽

Inversion Recovery ◽

Intravenous Contrast ◽

Spin Echo Sequence ◽

Tissue Contrast ◽

Intravenous Contrast Media

Abstract Background T1 inversion recovery (T1IR) sequence improved tissue contrast by providing higher gray matter-white matter contrast ratio (GM-WM contrast ratio) and higher lesion contrast noise ratio (CNR). This study aims to highlight its significance in the evaluation of space-occupying lesions whether intra-axial or extra-axial and also in multiple sclerosis (MS) by comparing it with T1 spin echo (T1SE) sequence. Result In a total of 50 patients, 14 patients with extra-axial lesions, 18 patients with intra-axial lesions, and 18 patients with multiple sclerosis were included. The CNR was significantly higher for pre-contrast T1IR images than for pre-contrast T1SE (− 13.04 (1.20) vs − 7.73 (0.70); p value < 0.01). After giving intravenous contrast media, CNR in T1SE was higher than T1IR (11.14 (1.75) vs 9.41 (1.83)) without statistical significance (p value = 0.19) and CNR was higher in T1IR than T1SE in lesions with low enhancement ratio (ER). As well, the overall number of lesions was higher on T1IR especially in MS (10.67 (2.26) vs 3.89 (1.05); p value < 0.01). Conclusion On pre-contrast sequences, T1IR could be used as an added sequence in most brain lesions giving higher lesion CNR. After giving intravenous contrast media, T1IR could be used in lesions with low ER. It also could be used in situations in which gadolinium injection is contraindicated and also could be used in follow-up of MS patient by detecting a higher number of lesions that can be easily missed in T1SE.

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CSF proteome in multiple sclerosis subtypes related to brain lesion transcriptomes

Scientific Reports ◽

10.1038/s41598-021-83591-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Maria L. Elkjaer ◽

Arkadiusz Nawrocki ◽

Tim Kacprowski ◽

Pernille Lassen ◽

Anja Hviid Simonsen ◽

...

Keyword(s):

Multiple Sclerosis ◽

Protein Phosphatase ◽

Brain Lesion ◽

Brain Lesions ◽

Cns Diseases ◽

Secondary Progressive ◽

Apolipoprotein A ◽

Proteomic Approach ◽

Apolipoprotein C ◽

Altered Proteins

AbstractTo identify markers in the CSF of multiple sclerosis (MS) subtypes, we used a two-step proteomic approach: (i) Discovery proteomics compared 169 pooled CSF from MS subtypes and inflammatory/degenerative CNS diseases (NMO spectrum and Alzheimer disease) and healthy controls. (ii) Next, 299 proteins selected by comprehensive statistics were quantified in 170 individual CSF samples. (iii) Genes of the identified proteins were also screened among transcripts in 73 MS brain lesions compared to 25 control brains. F-test based feature selection resulted in 8 proteins differentiating the MS subtypes, and secondary progressive (SP)MS was the most different also from controls. Genes of 7 out these 8 proteins were present in MS brain lesions: GOLM was significantly differentially expressed in active, chronic active, inactive and remyelinating lesions, FRZB in active and chronic active lesions, and SELENBP1 in inactive lesions. Volcano maps of normalized proteins in the different disease groups also indicated the highest amount of altered proteins in SPMS. Apolipoprotein C-I, apolipoprotein A-II, augurin, receptor-type tyrosine-protein phosphatase gamma, and trypsin-1 were upregulated in the CSF of MS subtypes compared to controls. This CSF profile and associated brain lesion spectrum highlight non-inflammatory mechanisms in differentiating CNS diseases and MS subtypes and the uniqueness of SPMS.

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Amide proton transfer imaging for differentiation of tuberculomas from high-grade gliomas: Preliminary experience

The Neuroradiology Journal ◽

10.1177/19714009211002766 ◽

2021 ◽

pp. 197140092110027

Author(s):

Karthik Kulanthaivelu ◽

Shumyla Jabeen ◽

Jitender Saini ◽

Sanita Raju ◽

Atchayaram Nalini ◽

...

Keyword(s):

Proton Transfer ◽

Chemical Exchange ◽

Spin Echo ◽

Chemical Exchange Saturation Transfer ◽

Amide Proton ◽

High Grade ◽

Saturation Pulse ◽

Amide Proton Transfer ◽

High Grade Gliomas ◽

Amide Protons

Purpose Tuberculomas can occasionally masquerade as high-grade gliomas (HGG). Evidence from magnetisation transfer (MT) imaging suggests that there is lower protein content in the tuberculoma microenvironment. Building on the principles of chemical exchange saturation transfer and MT, amide proton transfer (APT) imaging generates tissue contrast as a function of the mobile amide protons in tissue’s native peptides and intracellular proteins. This study aimed to further the understanding of tuberculomas using APT and to compare it with HGG. Method Twenty-two patients ( n = 8 tuberculoma; n = 14 HGG) were included in the study. APT was a 3D turbo spin-echo Dixon sequence with inbuilt B0 correction. A two-second, 2 μT saturation pulse alternating over transmit channels was applied at ±3.5 ppm around water resonance. The APT-weighted image (APTw) was computed as the MT ratio asymmetry (MTRasym) at 3.5 ppm. Mean MTRasym values in regions of interest (areas = 9 mm2; positioned in component with homogeneous enhancement/least apparent diffusion coefficient) were used for the analysis. Results MTRasym values of tuberculomas ( n = 14; 8 cases) ranged from 1.34% to 3.11% ( M = 2.32 ± 0.50). HGG ( n = 17;14 cases) showed MTRasym ranging from 2.40% to 5.70% ( M = 4.32 ± 0.84). The inter-group difference in MTRasym was statistically significant ( p < 0.001). APTw images in tuberculomas were notable for high MTRasym values in the perilesional oedematous-appearing parenchyma (compared to contralateral white matter; p < 0.001). Conclusion Tuberculomas demonstrate lower MTRasym ratios compared to HGG, reflective of a relative paucity of mobile amide protons in the ambient microenvironment. Elevated MTRasym values in perilesional parenchyma in tuberculomas are a unique observation that may be a clue to the inflammatory milieu.

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Elucidating distinct clinico-radiologic signatures in the borderland between neuromyelitis optica and multiple sclerosis

Journal of Neurology ◽

10.1007/s00415-021-10619-1 ◽

2021 ◽

Author(s):

Maciej Juryńczyk ◽

Elżbieta Klimiec-Moskal ◽

Yazhuo Kong ◽

Samuel Hurley ◽

Silvia Messina ◽

...

Keyword(s):

Multiple Sclerosis ◽

Neuromyelitis Optica ◽

Unmet Need ◽

Transverse Myelitis ◽

Overlap Syndrome ◽

Brain Lesions ◽

Central Vein ◽

Normal Brain ◽

Group 4 ◽

Group 2

Abstract Background Separating antibody-negative neuromyelitis optica spectrum disorders (NMOSD) from multiple sclerosis (MS) in borderline cases is extremely challenging due to lack of biomarkers. Elucidating different pathologies within the likely heterogenous antibody-negative NMOSD/MS overlap syndrome is, therefore, a major unmet need which would help avoid disability from inappropriate treatment. Objective In this study we aimed to identify distinct subgroups within the antibody-negative NMOSD/MS overlap syndrome. Methods Twenty-five relapsing antibody-negative patients with NMOSD features underwent a prospective brain and spinal cord MRI. Subgroups were identified by an unsupervised algorithm based on pre-selected NMOSD/MS discriminators. Results Four subgroups were identified. Patients from Group 1 termed “MS-like” (n = 6) often had central vein sign and cortical lesions (83% and 67%, respectively). All patients from Group 2 (“spinal MS-like”, 8) had short-segment myelitis and no MS-like brain lesions. Group 3 (“classic NMO-like”, 6) had high percentage of bilateral optic neuritis and longitudinally extensive transverse myelitis (LETM, 80% and 60%, respectively) and normal brain appearance (100%). Group 4 (“NMO-like with brain involvement”, 5) typically had a history of NMOSD-like brain lesions and LETM. When compared with other groups, Group 4 had significantly decreased fractional anisotropy in non-lesioned tracts (0.46 vs. 0.49, p = 0.003) and decreased thalamus volume (0.84 vs. 0.98, p = 0.04). Conclusions NMOSD/MS cohort contains distinct subgroups likely corresponding to different pathologies and requiring tailored treatment. We propose that non-conventional MRI might help optimise diagnosis in these challenging patients.

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