scholarly journals A Comparison of Magnetic Resonance Imaging Methods to Assess Multiple Sclerosis Lesions: Implications for Patient Characterization and Clinical Trial Design

Diagnostics ◽  
2021 ◽  
Vol 12 (1) ◽  
pp. 77
Author(s):  
Ewart Mark Haacke ◽  
Evanthia Bernitsas ◽  
Karthik Subramanian ◽  
David Utriainen ◽  
Vinay Kumar Palutla ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
White Matter ◽  
Magnetic Resonance ◽  
Inversion Recovery ◽  
Resonance Imaging ◽  
Imaging Protocol ◽  
Imaging Methods ◽  
Water Fraction ◽  
Demyelinating Lesions ◽  
Myelin Water Fraction

Magnetic resonance imaging (MRI) is a sensitive imaging modality for identifying inflammatory and/or demyelinating lesions, which is critical for a clinical diagnosis of MS and evaluating drug responses. There are many unique means of probing brain tissue status, including conventional T1 and T2 weighted imaging (T1WI, T2WI), T2 fluid attenuated inversion recovery (FLAIR), magnetization transfer, myelin water fraction, diffusion tensor imaging (DTI), phase-sensitive inversion recovery and susceptibility weighted imaging (SWI), but no study has combined all of these modalities into a single well-controlled investigation. The goals of this study were to: compare different MRI measures for lesion visualization and quantification; evaluate the repeatability of various imaging methods in healthy controls; compare quantitative susceptibility mapping (QSM) with myelin water fraction; measure short-term longitudinal changes in the white matter of MS patients and map out the tissue properties of the white matter hyperintensities using STAGE (strategically acquired gradient echo imaging). Additionally, the outcomes of this study were anticipated to aid in the choice of an efficient imaging protocol reducing redundancy of information and alleviating patient burden. Of all the sequences used, T2 FLAIR and T2WI showed the most lesions. To differentiate the putative demyelinating lesions from inflammatory lesions, the fusion of SWI and T2 FLAIR was used. Our study suggests that a practical and efficient imaging protocol combining T2 FLAIR, T1WI and STAGE (with SWI and QSM) can be used to rapidly image MS patients to both find lesions and study the demyelinating and inflammatory characteristics of the lesions.

scholarly journals Demyelinating lesions behaving like aggressive tumours on advanced MRI techniques

2019 ◽  
Vol 32 (2) ◽  
pp. 103-107 ◽  
Author(s):  
Brainner Campos Barbosa ◽  
Edson Marchiori ◽  
Caio Leal Leidersnaider ◽  
Lara Brandao ◽  
Mauricio Castillo
Keyword(s):  
Magnetic Resonance Imaging ◽  
White Matter ◽  
Magnetic Resonance ◽  
High Grade ◽  
Conventional Magnetic Resonance Imaging ◽  
Resonance Imaging ◽  
High Permeability ◽  
Conventional Magnetic Resonance ◽  
Demyelinating Lesions ◽  
High Grade Gliomas

Tumefactive demyelinating lesions are a rare disorder in which inflammatory demyelination manifests as solitary or multiple focal brain lesions (greater than 2 cm in size), which can be mistaken for glioma, lymphoma, metastasis and in some cases even brain abscess. The symptomatology of tumefactive demyelinating lesions depends on the white matter area involved and includes quickly progressing neurological deterioration of motor, sensory and visual function, praxis, language and mood impairment, as well as seizures. Recognising the key imaging features in a patient with a prior history of demyelination may expedite appropriate management. Preoperative diagnosis or at least the consideration of a demyelinating process is important to avoid unnecessary surgery. We report three patients with demyelinating lesions who presented with findings suggestive of demyelination on conventional magnetic resonance imaging studies. However, in all patients the lesions showed high perfusion and in two high permeability, which are findings generally seen with high-grade neoplasias. In rare instances, tumefactive demyelinating lesions may show increased perfusion and high permeability, imaging findings more commonly seen in high-grade gliomas. We suggest that if white matter lesions on conventional magnetic resonance imaging are compatible with tumefactive demyelinating lesions, atypical findings of high perfusion/permeability should not dissuade the radiologist from suggesting the presence of tumefactive demyelinating lesions rather than high-grade gliomas.

Corticospinal tract integrity measured using transcranial magnetic stimulation and magnetic resonance imaging in neuromyelitis optica and multiple sclerosis

2015 ◽  
Vol 22 (1) ◽  
pp. 43-50 ◽  
Author(s):  
Praveena Manogaran ◽  
Irene Vavasour ◽  
Michael Borich ◽  
Shannon H Kolind ◽  
Alex P Lange ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Resonance ◽  
Magnetic Stimulation ◽  
Corticospinal Tract ◽  
Resonance Imaging ◽  
Recruitment Curve ◽  
Water Fraction ◽  
Myelin Water Fraction

Background: Both multiple sclerosis (MS) and neuromyelitis optica (NMO) can present with transverse myelitis; however, NMO symptoms are usually more severe and may present with more extensive axonal loss. Transcranial magnetic stimulation (TMS)-based input–output recruitment curves can quantitatively assess the excitability of corticospinal tract pathways and myelin water imaging can quantify the amount of myelin within this same pathway. Objective: To compare differential effects of MS and NMO on TMS recruitment curves and myelin water imaging. Methods: Ten healthy controls, 10 individuals with MS and 10 individuals with NMO completed clinical assessments, a TMS assessment and magnetic resonance imaging scan to measure recruitment curves and myelin water fraction in the corticospinal tract. Results: Individuals with NMO had lower recruitment curve slopes (mean 13.6±6 μV/%) than MS (23.6±11 μV/%) and controls (21.9±9 μV/%, analysis of variance (ANOVA) P=0.05). Corticospinal tract myelin water fraction was lower in individuals with NMO (mean 0.17±0.02) compared to MS (0.19±0.02) and controls (0.20±0.02, ANOVA P=0.0006). Conclusion: Corticospinal pathway damage in individuals with NMO was evident by reduced recruitment curve slope and lower myelin water fraction. These specific measures of corticospinal function and structure may be used to obtain a better understanding and monitor brain injury caused by inflammatory central nervous system disorders.

Encephalocoele as a complication of intranasal sinus surgery: optimal evaluation with magnetic resonance imaging

1998 ◽  
Vol 112 (8) ◽  
pp. 790-792 ◽  
Author(s):  
Leo J. Wolansky ◽  
Peter K. Chiang ◽  
John Zurlo ◽  
Soly Baredes ◽  
Stephen R. Baker
Keyword(s):  
Magnetic Resonance Imaging ◽  
White Matter ◽  
Magnetic Resonance ◽  
Nasal Mucosa ◽  
Inversion Recovery ◽  
Sinus Surgery ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Optimal Evaluation ◽  
Fast Inversion

AbstractWe report a case of post-operative frontal basal encephalocoele evaluated using a new magnetic resonance imaging (MRI) sequence, fast inversion recovery for myelin suppression (FIRMS). FIRMS was developed to enhance the differentiation between grey and white matter. In this case, the sequence was beneficial in distinguishing the encephalocoele from adjacent nasal mucosa and secretions.

scholarly journals Magnetic Resonance Imaging (MRI) Double Inversion Recovery Sequence in Diagnosis of Multiple Sclerosis

2021 ◽  
pp. 47-55
Author(s):  
Ahmed Samir Ghonim ◽  
Rasha Lotfy Younes ◽  
Mohamed Amin Mohamed ◽  
Mohamed Fathy Dawoud
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
White Matter ◽  
Magnetic Resonance ◽  
Inversion Recovery ◽  
University Hospital ◽  
Double Inversion Recovery ◽  
P Value ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri

Aims: The current work aimed to assess the diagnostically value of Magnetic Resonance Imaging (MRI) Double Inversion Recovery (DIR) sequence in diagnosing of multiple sclerosis. Methodology: This study conducted on (42 patients) from the Diagnostic Radiology and Medical Imaging Dep. at Tanta University Hospital in the period from March 2018 to December 2019. Results: In accordance to the total lesions loads, it was found that DIR was higher significantly than T2WI (P-value= 0.003 with a relative gaining of 22%), we found that double inversion recovery (DIR) sequence was higher significantly to FLAIR regarding the number of diagnosed lesions in 3 anatomical areas (Mixed W-GM, cortical and infra-tentorial) with relative gaining of 28%, 85% and 63% respectively. A non-significant change was found among the two sequences regarding peri-ventricular white matter, deep white matter and juxta-cortical lesions detecting. Conclusion: Conventionally MRI has corner-stone roles in diagnosing, characterizing and following-up of multi-sclerosis. Finally, we concluded that DIR can be used as a addition to or even as an alternative for typical T2 and FLAIR. Therefore, we strongly recommend the addition of DIR sequences in the everyday MR protocol of MS cases.

Brain magnetic resonance imaging findings in relapsing neuromyelitis optica

2007 ◽  
Vol 13 (2) ◽  
pp. 186-192 ◽  
Author(s):  
José A Cabrera-Gómez ◽  
L Quevedo-Sotolongo ◽  
A González-Quevedo ◽  
S Lima ◽  
Y Real-González ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Multiple Sclerosis ◽  
White Matter ◽  
Magnetic Resonance ◽  
Neuromyelitis Optica ◽  
Brain Mri ◽  
Brain Magnetic Resonance Imaging ◽  
Resonance Imaging ◽  
Imaging Protocol ◽  
The Brain

Background Some studies showed abnormalities in brain magnetic resonance imaging (MRI) of relapsing neuromyelitis optica (R-NMO) from 12 to 46%. These abnormalities are described as compatible/non-compatible with multiple sclerosis (MS). Objective To describe the abnormal brain MRI lesions in R-NMO with imaging studies conducted with more sensitive white matter change techniques. Methods Thirty patients with R-NMO were selected. All MRI brain studies were performed with a 1.5-T Siemens MRI system according to the Standardized MR Imaging Protocol for Multiple Sclerosis from the Consortium of MS Centers Consensus Guidelines. Results Brain MRI images were evaluated in 29 R-NMO cases because in one case the MRI images were not appropriate for the study. Of these 29 brain MRI studies, 19 cases (65.5%) had at least one or more lesions (1–57) and 10 were negative (34.4%). Brain MRI findings in 19 cases were characterized in T2/fluid-attenuated inversion-recovery (FLAIR) by the presence of subcortical/deep white matter lesions in 16 (84.2%) cases (1–50), most of them < 3 mm and without juxtacortical localization. Periventricular lesions were observed in 13 (68.4%) cases, but morphologically they were not oval, ovoid or perpendicularly orientated. Infratentorial lesions, all >3 mm, were observed in 4 (21.05%) cases without cerebellar involvement. T1 studies demonstrated absence of hypointense regions. Optic nerve enhancement was observed in 6/19 patients (31.5%). None of the brain MRI abnormalities observed were compatible with Barkhof et al. criteria of MS. Conclusions This study, based on a Cuban patient population, with long duration of disease, good sample size and detailed characterization by MRI, demonstrated the brain MRI pattern of R-NMO patients, which is different from MS. Multiple Sclerosis 2007; 13: 186–192. http://msj.sagepub.com

scholarly journals Balo’s Concentric Sclerosis Mimicking Tumor on Magnetic Resonance Imaging in a Young Patient

2021 ◽  
Vol 14 ◽  
pp. 117954762198967
Author(s):  
Van Trung Hoang ◽  
Cong Thao Trinh ◽  
Hoang Anh Thi Van ◽  
Thanh Tam Thi Nguyen ◽  
Vichit Chansomphou ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Demyelinating Disease ◽  
Management Strategies ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Demyelinating Lesions ◽  
Baló’S Concentric Sclerosis ◽  
Magnetic Resonance Imaging Mri ◽  
Subcortical Regions

Balo’s concentric sclerosis (BCS) is a rare demyelinating disease known as Multiple Sclerosis (MS) lesion type III. It is a disease of the white matter of the brain characterized by a round lesion with variable concentric myelinated and demyelinated layers, appearing as “onion bulb.” We present a case of BCS and discuss the imaging findings and management strategies of this disease. A 26-y-old male developed headache, weakness, and numbness of limbs. Magnetic resonance imaging (MRI) showed concentric lamellar like demyelinating lesions at the subcortical regions. The patient’s neurological symptoms were consistent with the MRI findings.

scholarly journals Magnetic resonance imaging findings in children with Parry-Romberg syndrome and en coup de sabre

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Harry Knights ◽  
Elizabeth Minas ◽  
Faraan Khan ◽  
Lindsay Shaw ◽  
Muthana Al Obaidi ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
White Matter ◽  
Magnetic Resonance ◽  
Brain Imaging ◽  
Case Series ◽  
Dystrophic Calcification ◽  
Resonance Imaging ◽  
Cutaneous Manifestations ◽  
Street Hospital ◽  
Parry Romberg Syndrome

Abstract Background The aim of this study was to: (i) describe the abnormalities seen on brain imaging in a group of children with en coup de sabre (EDCS) with/without Parry-Romberg syndrome (PRS); and (ii) identify clinical predictors of brain imaging abnormalities. Methods This was a single centre (Great Ormond Street Hospital, London) retrospective case series of patients with ECDS/PRS seen from 2000 to 2018. We identified patients with cutaneous manifestations consistent with the clinical descriptions of ECDS/PRS. Presenting clinical, laboratory, and radiological brain findings are described. Results are expressed as medians and ranges or frequencies and percentages. Fisher’s exact test was used to identify clinical associations with magnetic resonance imaging (MRI) abnormalities. Results Fourteen patients were studied: 6 males and 8 females; median age 14 years (range 3–20). We observed neuroimaging abnormalities in 2/6 ECDS and 5/8 ECDS/PRS patients. White matter signal abnormality, dystrophic calcification, leptomeningeal enhancement, and sulcal crowding were the typical findings on brain imaging. A total of 50% of patients had no MRI abnormality despite some of these patients having neurological symptoms. The presence of seizures was significantly associated with ipsilateral enhanced white matter signalling on MRI (p < 0.05). Conclusions In summary, we observed several distinct radiographic patterns associated with ECDS/PRS. Seizure disorder was strongly associated with the presence of ipsilateral enhanced white matter signalling. Improved neuroimaging techniques that combine morphological with functional imaging may improve the detection rate of brain involvement in children with ECDS/PRS in the future.

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