Comparison of diffusion-weighted imaging and enhanced T1-weighted sequencing in patients with multiple sclerosis

Introduction The purpose of this study was to assess whether demographic, brain anatomical regions and contrast enhancement show differences in multiple sclerosis (MS) patients with increased diffusion lesions (ID group) compared with diffusion restriction (DR group). Method MRI protocol comprised T1- and T2-weighted sequences with and without gadolinium (Gd), and sagittal three-dimensional FLAIR sequence, DWI and ADC maps were prospectively performed in 126 MS patients from January to December 2015. The investigation was conducted to evaluate differences in demographic, cord and brain regional, technical, and positive or negative Gd contrast imaging parameters in two groups of ID and DR. Statistical analysis was performed by using SPSS. Results A total of 9.6% of patients showed DR. In the DR group, 66.6% of the patients showed contrast enhancement of plaques, whereas 29.2% of the IR group showed enhancement of plaques. The most prevalent group was non-enhanced plaques in the ID group, followed by Gd-enhanced plaques in the ID group. Patients in the ID group (90.4%) were significantly more than in the DR group (9.6%). Out of the 40 patients with Gd-enhanced plaques, 80.5% was from the ID group and 19.5% from the DR group. Conclusion MRI of the brain, unlike of the cord, with Gd demonstrates significant difference in enhancement between the two groups ( p < 0.05). No significant difference was seen in demographic, cord and brain regional, and technical parameters, EDSS, disease duration, and attack rate as well as demographic and regional parameters between the ID and decrease diffusion groups ( p > 0.05).

Download Full-text

Longitudinal Brain Size Measurements in App/Ps1 Transgenic Mice

Magnetic Resonance Insights ◽

10.4137/mri.s5885 ◽

2010 ◽

Vol 4 ◽

pp. MRI.S5885 ◽

Cited By ~ 3

Author(s):

Trevor J. Vincent ◽

Jonathan D. Thiessen ◽

Laryssa M. Kurjewicz ◽

Shelley L. Germscheid ◽

Allan J. Turner ◽

...

Keyword(s):

Brain Size ◽

Three Dimensional ◽

Gene Mutations ◽

Mutant Form ◽

Swedish Mutation ◽

Significant Difference ◽

Lateral Width ◽

Resolution Imaging ◽

Or Gene ◽

The Brain

There appear to be species differences among the effects of gene mutations related to familial Alzheimer's disease on the brain during aging. To gain a better understanding of the effects of the Swedish mutation of amyloid precursor protein and the mutant form of human presenilin 1 on mice, commercially available mice from Jackson Laboratory were studied. Three dimensional T2*-weighted imaging was used to monitor the size of brains of APP/PS1 mice monthly, from 6 to 13 months of age. No significant difference was measured in the size of the medial-lateral width, dorsal-ventral height, rostral-caudal length or the volume of the APPSwe/ PS1 mouse brain. Faster and higher-resolution imaging methods are needed to accurately determine if small volume or shape changes occur in mouse brains with age or gene mutations.

Download Full-text

On the microstructural origin of brain white matter hydraulic permeability

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.2105328118 ◽

2021 ◽

Vol 118 (36) ◽

pp. e2105328118

Author(s):

Marco Vidotto ◽

Andrea Bernardini ◽

Marco Trovatelli ◽

Elena De Momi ◽

Daniele Dini

Keyword(s):

White Matter ◽

Corpus Callosum ◽

Drug Transport ◽

Three Dimensional ◽

Principal Component ◽

Hydraulic Permeability ◽

Convection Enhanced Delivery ◽

Brain White Matter ◽

Significant Difference ◽

The Brain

Brain microstructure plays a key role in driving the transport of drug molecules directly administered to the brain tissue, as in Convection-Enhanced Delivery procedures. The proposed research analyzes the hydraulic permeability of two white matter (WM) areas (corpus callosum and fornix) whose three-dimensional microstructure was reconstructed starting from the acquisition of electron microscopy images. We cut the two volumes with 20 equally spaced planes distributed along two perpendicular directions, and, on each plane, we computed the corresponding permeability vector. Then, we considered that the WM structure is mainly composed of elongated and parallel axons, and, using a principal component analysis, we defined two principal directions, parallel and perpendicular, with respect to the axons’ main direction. The latter were used to define a reference frame onto which the permeability vectors were projected to finally obtain the permeability along the parallel and perpendicular directions. The results show a statistically significant difference between parallel and perpendicular permeability, with a ratio of about two in both the WM structures analyzed, thus demonstrating their anisotropic behavior. Moreover, we find a significant difference between permeability in corpus callosum and fornix, which suggests that the WM heterogeneity should also be considered when modeling drug transport in the brain. Our findings, which demonstrate and quantify the anisotropic and heterogeneous character of the WM, represent a fundamental contribution not only for drug-delivery modeling, but also for shedding light on the interstitial transport mechanisms in the extracellular space.

Download Full-text

Postcontrast Fluid-Attenuated Inversion Recovery (FLAIR) Sequence MR Imaging in Detecting Intracranial Pathology

Radiology Research and Practice ◽

10.1155/2020/8853597 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9

Author(s):

Ajit Mahale ◽

Shaloo Choudhary ◽

Sonali Ullal ◽

Merwyn Fernandes ◽

Sonali Prabhu

Keyword(s):

Multiple Sclerosis ◽

Mr Imaging ◽

Observational Study ◽

Low Grade ◽

Meningeal Enhancement ◽

Axial Parenchyma ◽

Flair Imaging ◽

Flair Sequence ◽

Fluid Attenuated Inversion Recovery ◽

The Brain

Background. Imaging sequences for detection of meningeal and parenchymal lesions are critical in intracranial pathology. Our study analysed FLAIR MRI sequence for evaluating postcontrast enhancement. Objectives. FLAIR imaging sequences have been used in evaluation of enhancement in the brain. We conducted a study of FLAIR imaging sequences to better delineate postcontrast enhancement. Materials and Methods. In this prospective hospital-based observational study, postcontrast T1 MTC and delayed postcontrast T2 FLAIR and T1 FLAIR images of 66 patients with intracranial pathology were assessed by experienced radiologists from November 2017 to November 2019. Results. 28 cases of meningeal enhancement were identified in delayed postcontrast T2 FLAIR images. Low-grade gliomas included in the study showed postcontrast enhancement on postcontrast T1 MTC images. Multiple sclerosis lesions were better seen on postcontrast T1 FLAIR. In extraaxial lesions of 11 cases of meningioma, brighter enhancement was seen on delayed postcontrast T2 FLAIR images. Conclusion. We found that delayed postcontrast T2 FLAIR was better in detection of meningeal enhancement in infectious meningitis and in meningitis carcinomatosis than T1 MTC images. In delayed postcontrast T2 FLAIR images, intra-axial parenchyma lesions appeared more conspicuous or similar to T1 MTC images. Delayed postcontrast T1 FLAIR images provided better anatomic delineation of intra-axial lesions.

Download Full-text

Leptomeningeal Contrast Enhancement Is Associated with Disability Progression and Grey Matter Atrophy in Multiple Sclerosis

Neurology Research International ◽

10.1155/2017/8652463 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 18

Author(s):

Gleb Makshakov ◽

Evgeniy Magonov ◽

Natalia Totolyan ◽

Vladimir Nazarov ◽

Sergey Lapin ◽

...

Keyword(s):

Multiple Sclerosis ◽

Contrast Enhancement ◽

Grey Matter ◽

Disease Duration ◽

Ventricular Volume ◽

Cortical Atrophy ◽

Grey Matter Volume ◽

Flair Sequence ◽

Edss Score ◽

Grey Matter Atrophy

Leptomeningeal contrast enhancement (LMCE) on magnetic resonance imaging (MRI) is a newly recognized possible biomarker in multiple sclerosis (MS), associated with MS progression and cortical atrophy. In this study, we aimed to assess the prevalence of LMCE foci and their impact on neurodegeneration and disability. Materials. 54 patients with MS were included in the study. LMCE were detected with a 3 Tesla scanner on postcontrast fluid-attenuated inversion-recovery (FLAIR) sequence. Expanded Disability Status Scale (EDSS) score, number of relapses during 5 years from MS onset, and number of contrast-enhancing lesions on T1 weighted MRI were counted. Results. LMCE was detected in 41% (22/54) of patients. LMCE-positive patients had longer disease duration (p=0,0098) and higher EDSS score (p=0,039), but not a higher relapse rate (p=0,091). No association of LMCE with higher frequency of contrast-enhancing lesions on T1-weighted images was detected (p=0,3842). Analysis of covariates, adjusted for age, sex, and disease duration, revealed a significant effect of LMCE on the cortex volume (p=0.043, F=2.529), the total grey matter volume (p=0.043, F=2.54), and total ventricular volume (p=0.039, F=2.605). Conclusions. LMCE was shown to be an independent and significant biomarker of grey matter atrophy and disability in MS.

Download Full-text

Lesion load assessment among multiple sclerosis patient using DIR, FLAIR, and T2WI sequences

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-020-00312-0 ◽

2020 ◽

Vol 51 (1) ◽

Author(s):

Abdullah Dhaifallah Almutairi ◽

Hasyma Abu Hassan ◽

Subapriya Suppiah ◽

Othman I. Alomair ◽

Abdulbaset Alshoaibi ◽

...

Keyword(s):

Multiple Sclerosis ◽

Neurological Disorders ◽

Lesion Detection ◽

Inversion Recovery ◽

Daily Routine ◽

Lesion Load ◽

Significant Difference ◽

Fluid Attenuated Inversion Recovery ◽

Magnetic Resonance Imaging Mri ◽

The Brain

Abstract Background Magnetic resonance imaging (MRI) is one of the diagnostic imaging modalities employing in lesion detection in neurological disorders such as multiple sclerosis (MS). Advances in MRI techniques such as double inversion recovery (DIR) made it more sensitive to distinguish lesions in the brain. To investigate the lesion load on different anatomical regions of the brain with MS using DIR, fluid attenuated inversion recovery (FLAIR) and T2-weighted imaging (T2WI) sequences. A total of 97 MS patients were included in our retrospective study, confirmed by neurologist. The patients were randomly selected from the major hospital in Saudi Arabia. All images were obtained using 3T Scanner (Siemens Skyra). The images from the DIR, FLAIR, and T2WI sequence were compared on axial planes with identical anatomic position and the number of lesions was assigned to their anatomical region. Results Comparing the lesion load measurement at various brain anatomical regions showed a significant difference among those three methods (p < 0.05). Conclusion DIR is a valuable MRI sequence for better delineation, greater contrast measurements and the increasing total number of MS lesions in MRI, compared with FLAIR, and T2WI and DIR revealed more intracortical lesions as well; therefore, in MS patients, it is recommended to add DIR sequence in daily routine imaging sequences.

Download Full-text

Correlation of sexual dysfunction and brain magnetic resonance imaging in multiple sclerosis

Multiple Sclerosis Journal ◽

10.1191/1352458503ms881sr ◽

2003 ◽

Vol 9 (1) ◽

pp. 108-110 ◽

Cited By ~ 21

Author(s):

M Zorzon ◽

R Zivadinov ◽

L Locatelli ◽

B Stival ◽

D Nasuelli ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Multiple Sclerosis ◽

Magnetic Resonance ◽

Sexual Dysfunction ◽

Bladder Dysfunction ◽

Resonance Imaging ◽

Whole Brain ◽

Total Brain ◽

Significant Difference ◽

The Brain

Sixty-two patients (40 women and 22 men) with multiple sclerosis (MS) were examined with 1.5 tesla magnetic resonance imaging (MRI) of the brain. Information on sexual and sphincteric disturbances has been collected, and data on disability, independence, cognitive performances and psychological functioning have been assessed. C alculations of T1- and T2-lesion load (LL) of total brain, frontal lobes and pons have been performed using a reproducible semiautomated technique. Whole brain, frontal and pontine atrophies were estimated using a normalized measure, the brain parenchymal fraction (BPF), obtained with a computerized interactive program. When comparing patients with and without sexual dysfunction (SD), there were no differences in total brain, frontal and pontine T1- and T2-LL, as well as in measures of whole brain and frontal atrophy. The only significant difference was in the pontine BPF (P-0.026). In linear multiple regression analysis, SD was associated with depression (R-0.56, P-0.001) and, after adjusting for depression and anxiety, with bladder dysfunction (R-0.43, P-0.003) and pontine BPF (R-0.56, P-0.001). No association between SD and any of the measures of T1- and T2-LL was found. The findings showed a relationship between SD and pontine atrophy, confirmed the correlation of SD with bladder dysfunction and highlighted the role of psychological factors in determining SD.

Download Full-text

Comparative study between double inversion recovery (DIR) and fluid-attenuated inversion recovery (FLAIR) MRI sequences for detection of cerebral lesions in multiple sclerosis

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-020-00298-9 ◽

2020 ◽

Vol 51 (1) ◽

Author(s):

Shaima Fattouh Elkholy ◽

Marianne Abdallah Sabet ◽

Mohammad Edrees Mohammad ◽

Ramy Edward Ibrahim Asaad

Keyword(s):

Multiple Sclerosis ◽

Pulse Sequence ◽

Brain Lesions ◽

Inversion Recovery ◽

Double Inversion Recovery ◽

Cerebral Lesions ◽

Flair Imaging ◽

Flair Sequence ◽

Scan Time ◽

Significant Difference

Abstract Background Multiple sclerosis (MS) is a common chronic inflammatory demyelinating disorder more common in young adults. MS is characterized mainly with white matter (WM) affection; however, considerable gray matter (GM) involvement is also noted in many patients. MRI is used for diagnosis and follow up of the disease using different pulse sequences; FLAIR imaging provides the highest sensitivity in the detection of supratentorial, juxtacortical, and the periventricular lesions but is less sensitive in the posterior fossa. A double inversion recovery (DIR) pulse sequence was recently introduced to improve the visibility of GM lesions and especially cortical lesions. The aim of this study is to assess the role of DIR sequence in the detection of brain lesions in patients with MS compared to FLAIR sequence. Results DIR showed a significantly higher number of MS lesions in infratentorial region (2.9 ± 0.4 compared to 2.25 ± 0.3 in FLAIR) with a statistically significant difference (p = 0.002) and also in supratentorial periventricular regions (11.84 ± 8.07 in DIR and 11.31 ± 8.07 in FLAIR, p < 0.001). DIR imaging also demonstrated significantly more intracortical lesions (7.12 ± 1.2 compared to 1.4 ± 0.9 in FLAIR imaging) with a statistically significant difference (p < 0.001). On the other hand, corpus callosum lesions were significantly higher on FLAIR (0.84 ± 0.1) with respect to DIR imaging (0.68 ± 0.1) with a statistically significant difference in between (p = 0.025). Conclusion DIR is a powerful conventional MRI sequence for visualization of brain lesions in patients with MS and is superior to FLAIR sequence in detecting lesions in different locations, namely cortical, periventricular, and infratentorial regions; hence, DIR can be added to the MRI protocol of MS patients or even can replace FLAIR which would be of a good diagnostic value with only 80 s added to the scan time.

Download Full-text

Percutaneous glycerol rhizotomy for trigeminal neuralgia in patients with multiple sclerosis: a long-term retrospective cohort study

Journal of Neurosurgery ◽

10.3171/2019.1.jns183093 ◽

2020 ◽

Vol 132 (5) ◽

pp. 1405-1413 ◽

Cited By ~ 1

Author(s):

Michael D. Staudt ◽

Holger Joswig ◽

Gwynedd E. Pickett ◽

Keith W. MacDougall ◽

Andrew G. Parrent

Keyword(s):

Multiple Sclerosis ◽

Pain Relief ◽

Trigeminal Neuralgia ◽

Retrospective Chart Review ◽

Medication Usage ◽

Free Response ◽

Free Survival ◽

Time To Recurrence ◽

Significant Difference

OBJECTIVEThe prevalence of trigeminal neuralgia (TN) in patients with multiple sclerosis (MS-TN) is higher than in the general population (idiopathic TN [ITN]). Glycerol rhizotomy (GR) is a percutaneous lesioning surgery commonly performed for the treatment of medically refractory TN. While treatment for acute pain relief is excellent, long-term pain relief is poorer. The object of this study was to assess the efficacy of percutaneous retrogasserian GR for the treatment of MS-TN versus ITN.METHODSA retrospective chart review was performed, identifying 219 patients who had undergone 401 GR procedures from 1983 to 2018 at a single academic institution. All patients were diagnosed with medically refractory MS-TN (182 procedures) or ITN (219 procedures). The primary outcome measures of interest were immediate pain relief and time to pain recurrence following initial and repeat GR procedures. Secondary outcomes included medication usage and presence of periprocedural hypesthesia.RESULTSThe initial pain-free response rate was similar between groups (p = 0.726): MS-TN initial GR 89.6%; MS-TN repeat GR 91.9%; ITN initial GR 89.6%; ITN repeat GR 87.0%. The median time to recurrence after initial GR was similar between MS-TN (2.7 ± 1.3 years) and ITN (2.1 ± 0.6 years) patients (p = 0.87). However, there was a statistically significant difference in the time to recurrence after repeat GR between MS-TN (2.3 ± 0.5 years) and ITN patients (1.2 ± 0.2 years; p < 0.05). The presence of periprocedural hypesthesia was highly predictive of pain-free survival (p < 0.01).CONCLUSIONSPatients with MS-TN achieve meaningful pain relief following GR, with an efficacy comparable to that following GR in patients with ITN. Initial and subsequent GR procedures are equally efficacious.

Download Full-text