AI Article Synopsis
- Leptomeningeal contrast enhancement (LME) on T2-FLAIR MRI is linked to leptomeningeal inflammation in multiple sclerosis (MS), but often misses cases, with only ~25% detection in patients.
- An optimized 3D Real-IR MRI sequence was tested on 177 scans, revealing significantly higher prevalence of LME (73%) compared to T2-FLAIR (33%) and greater sensitivity with 3.7-fold more foci detected.
- Age was a key factor in LME status, and while LME was not linked to cortical lesions, it correlated with paramagnetic rim lesions, indicating Real-IR's potential for better identifying MS-related changes.
Article Abstract
Background: Leptomeningeal contrast enhancement (LME) on T2-weighted Fluid-Attenuated Inversion Recovery (T2-FLAIR) MRI is a reported marker of leptomeningeal inflammation, which is known to be associated with progression of multiple sclerosis (MS). However, this MRI approach, as typically implemented on clinical 3-tesla (T) systems, detects only a few enhancing foci in ~25% of patients and has thus been criticized as poorly sensitive.
Purpose: To compare an optimized 3D real-reconstruction inversion recovery (Real-IR) MRI sequence on a clinical 3 T scanner to T2-FLAIR for prevalence, characteristics, and clinical/radiological correlations of LME.
Materials And Methods: We obtained 3D T2-FLAIR and Real-IR scans before and after administration of standard-dose gadobutrol in 177 scans of 154 participants (98 women, 64%; mean ± SD age: 49 ± 12 years), including 124 with an MS-spectrum diagnosis, 21 with other neurological and/or inflammatory disorders, and 9 without neurological history. We calculated contrast-to-noise ratios (CNR) in 20 representative LME foci and determined association of LME with cortical lesions identified at 7 T (n = 19), paramagnetic rim lesions (PRL) at 3 T (n = 105), and clinical/demographic data.
Results: We observed focal LME in 73% of participants on Real-IR (70% in established MS, 33% in healthy volunteers, P < 0.0001), compared to 33% on T2-FLAIR (34% vs. 11%, P = 0.0002). Real-IR showed 3.7-fold more LME foci than T2-FLAIR ( P = 0.001), including all T2-FLAIR foci. LME CNR was 2.5-fold higher by Real-IR ( P < 0.0001). The major determinant of LME status was age. Although LME was not associated with cortical lesions, the number of PRL was associated with the number of LME foci on both T2-FLAIR ( P = 0.003) and Real-IR ( P = 0.0003) after adjusting for age, sex, and white matter lesion volume.
Conclusions: Real-IR a promising tool to detect, characterize, and understand the significance of LME in MS. The association between PRL and LME highlights a possible role of the leptomeninges in sustaining chronic inflammation.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10818009 | PMC |
| http://dx.doi.org/10.1097/RLI.0000000000001011 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Successful treatment of cardiac dysfunction due to left main trunk obstruction and severe acute aortic regurgitation secondary to acute type A aortic dissection using Impella: a case report.
J Cardiothorac Surg
December 2024
Department of Cardiovascular Surgery, Kanazawa University, Takaramachi 13-1, Kanazawa, 920-8641, Japan.
Background: Acute type A aortic dissection (A-AAD) with severe acute aortic regurgitation (AR) and coronary involvement is a potentially fatal condition that causes left ventricular volume overload and catastrophic acute myocardial infarction. We present the successful management of a patient using Impella 5.5 following cardiopulmonary arrest caused by A-AAD with severe acute AR and left main trunk (LMT) obstruction.
View Article and Find Full Text PDFDelayed-Onset White Matter Lesions on Brain MRI in Recurrent Non-cerebral Plasmodium falciparum Imported Malaria Without Neurological Symptoms.
Cureus
December 2024
Neurology, Adventist Health White Memorial, Los Angeles, USA.
malaria affects millions of people in certain regions of the world, with neurological involvement and/or cerebral malaria as potential manifestations. Brain magnetic resonance imaging (MRI) abnormalities have been well-documented in cerebral malaria. However, MRI abnormalities in non-cerebral malaria, especially in neurologically asymptomatic patients, are not well understood and have been less frequently reported, especially in non-endemic regions.
View Article and Find Full Text PDFMitigation of irreversible membrane biofouling by CNTs-PVDF conductive composite membrane.
Environ Res
December 2024
School of Environmental Science and Engineering, Tiangong University, State Key Laboratory of Separation Membranes and Membrane Processes, Binshui West Road 399, Xiqing District, Tianjin, 300387, PR China; Cangzhou Institute of Tiangong University, Cangzhou 061000, China. Electronic address:
Biofouling has been one of the major challenges impacting the long-term stable operation of ultrafiltration processes. Irreversible biofouling is considerably more harmful than reversible biofouling. Conductive membrane, as a new technology to effectively mitigate membrane fouling, lack research of controlling irreversible biofouling.
View Article and Find Full Text PDFCortical lesions impact cognitive decline in multiple sclerosis via volume loss of nonlesional cortex.
Ann Clin Transl Neurol
December 2024
MS Center Amsterdam, Department of Anatomy and Neurosciences, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Objective: To assess the interrelationship between cortical lesions and cortical thinning and volume loss in people with multiple sclerosis within cortical networks, and how this relates to future cognition.
Methods: In this longitudinal study, 230 people with multiple sclerosis and 60 healthy controls underwent 3 Tesla MRI at baseline and neuropsychological assessment at baseline and 5-year follow-up. Cortical regions (N = 212) were divided into seven functional networks.
Pediatric Neuroimaging of Multiple Sclerosis and Neuroinflammatory Diseases.
Tomography
December 2024
Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
Using a pediatric-focused lens, this review article briefly summarizes the presentation of several demyelinating and neuroinflammatory diseases using conventional magnetic resonance imaging (MRI) sequences, such as T1-weighted with and without an exogenous gadolinium-based contrast agent, T2-weighted, and fluid-attenuated inversion recovery (FLAIR). These conventional sequences exploit the intrinsic properties of tissue to provide a distinct signal contrast that is useful for evaluating disease features and monitoring treatment responses in patients by characterizing lesion involvement in the central nervous system and tracking temporal features with blood-brain barrier disruption. Illustrative examples are presented for pediatric-onset multiple sclerosis and neuroinflammatory diseases.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!