Disease correlates of rim lesions on quantitative susceptibility mapping in multiple sclerosis.

Quantitative susceptibility mapping (QSM), an imaging technique sensitive to brain iron, has been used to detect paramagnetic rims of iron-laden active microglia and macrophages in a subset of multiple sclerosis (MS) lesions, known as rim+ lesions, that are consistent with chronic active lesions. Because of the potential impact of rim+ lesions on disease progression and tissue damage, investigating their influence on disability and neurodegeneration is critical to establish the impact of these lesions on the disease course. This study aimed to explore the relationship between chronic active rim+ lesions, identified as having a hyperintense rim on QSM, and both clinical disability and imaging measures of neurodegeneration in patients with MS.

Dimethyl Fumarate Reduces Inflammation in Chronic Active Multiple Sclerosis Lesions.

Background And Objectives: To determine the effects of dimethyl fumarate (DMF) and glatiramer acetate on iron content in chronic active lesions in patients with multiple sclerosis (MS) and in human microglia in vitro.

Methods: This was a retrospective observational study of 34 patients with relapsing-remitting MS and clinically isolated syndrome treated with DMF or glatiramer acetate. Patients had lesions with hyperintense rims on quantitative susceptibility mapping, were treated with DMF or glatiramer acetate (GA), and had a minimum of 2 on-treatment scans.

Longitudinal change in magnetic susceptibility of new enhanced multiple sclerosis (MS) lesions measured on serial quantitative susceptibility mapping (QSM).

Purpose: To measure the longitudinal change in multiple sclerosis (MS) lesion susceptibility using quantitative susceptibility mapping (QSM).

Materials And Methods: The study was approved by our Institutional Review Board. Longitudinal changes in quantitative susceptibility values of new enhanced-with-Gd MS lesions were measured at baseline magnetic resonance imaging (MRI) and on a follow-up MRI in 29 patients within 2 years using a 3D multiple echo gradient echo sequence on a 3T scanner.

Gadolinium-Enhancing Lesions Lead to Decreases in White Matter Tract Fractional Anisotropy in Multiple Sclerosis.

Purpose: Although MRI identification of new lesions forms the basis for monitoring disease progression in multiple sclerosis patients, how lesion activity relates to longitudinal white matter changes in the brain is unknown. We hypothesized that patients with gadolinium-enhancing lesions would show greater longitudinal decline in fractional anisotropy in major tracts compared to those with stable disease.

Methods: Thirty patients with relapsing-remitting multiple sclerosis were included in this study-13 had enhancing lesions at baseline and 17 did not.

Surveillance after resection of vestibular schwannoma: measurement techniques and predictors of growth.

Objectives: To compare different methods of measuring tumor growth after resection of vestibular schwannoma and to identify predictors of growth.

Study Design: Retrospective case review.

Setting: Tertiary referral center, inpatient surgery with ambulatory follow-up.

Quantitative susceptibility mapping of multiple sclerosis lesions at various ages.

Purpose: To assess multiple sclerosis (MS) lesions at various ages by using quantitative susceptibility mapping (QSM) and conventional magnetic resonance (MR) imaging.

Materials And Methods: Retrospectively selected were 32 clinically confirmed MS patients (nine men and 23 women; 39.3 years ± 10.

Neuroimaging of cerebrovascular disease in the aging brain.

Cerebrovascular disease remains a significant public health burden with its greatest impact on the elderly population. Advances in neuroimaging techniques allow detailed and sophisticated evaluation of many manifestations of cerebrovascular disease in the brain parenchyma as well as in the intracranial and extracranial vasculature. These tools continue to contribute to our understanding of the multifactorial processes that occur in the age-dependent development of cerebrovascular disease.

Role of CT perfusion imaging in the diagnosis and treatment of vasospasm.

The current role of CT perfusion (CTP) imaging in the diagnosis and treatment of vasospasm in the setting of aneurysmal subarachnoid hemorrhage is discussed in this article, with specific attention directed towards defining the terminology of vasospasm and delayed cerebral ischemia. A commonly used CTP technique in clinical practice is described. A review of the literature regarding the usefulness of CTP for the diagnosis of vasospasm and its role in guiding treatment are discussed.

Outcomes-based assessment of a new reference standard for delayed cerebral ischemia related to vasospasm in aneurysmal subarachnoid hemorrhage.

Rationale And Objectives: The purpose is to perform outcomes-based assessment of a new reference standard for delayed cerebral ischemia (DCI) related to vasospasm.

Materials And Methods: Retrospective study was performed with consecutive aneurysmal subarachnoid hemorrhage (A-SAH) patients between January 2002 and May 2009. A new reference standard for DCI was applied to the study population incorporating clinical and imaging criteria.

Comparison of CT perfusion and digital subtraction angiography in the evaluation of delayed cerebral ischemia.

Rationale And Objectives: Delayed cerebral ischemia (DCI) is a devastating condition that occurs secondary to aneurysmal subarachnoid hemorrhage (A-SAH). The purpose is to compare computed tomography perfusion (CTP) and digital subtraction angiography (DSA) for determining DCI in A-SAH.

Materials And Methods: A retrospective study of A-SAH patients admitted at our institution between December 2004 and December 2008 was performed.

Developing a new reference standard: is validation necessary?

Rationale And Objectives: A gold standard is often an imperfect diagnostic test, falling short of achieving 100% accuracy in clinical practice. Using an imperfect gold standard without fully comprehending its limitations and biases can lead to erroneous classification of patients with and without disease. This will ultimately affect treatment decisions and patient outcomes.

Validation of a new reference standard for the diagnosis of vasospasm.

Rationale And Objectives: The purpose of our study is to perform an internal validation of a new reference standard for vasospasm diagnosis in aneurysmal subarachnoid hemorrhage (A-SAH) patients.

Materials And Methods: A retrospective study was performed on A-SAH patients between January 2002 and May 2009. All patients were applied to this new reference standard using a multistage hierarchical approach incorporating clinical and imaging criteria.