Magnetic Resonance Phase Alterations in Multiple Sclerosis Patients with Short and Long Disease Duration

Abstract

ObjectiveThe analysis of the MR phase provides additional information on the tissue microstructure. In multiple sclerosis (MS) lesions phase alterations may reflect different stages of inflammatory activity. Here we investigated lesion morphology in MS patients with short and long disease duration on T2* weighted, phase, magnitude and susceptibility weighted imaging (SWI) at 7 Tesla (T).Methods17 MS or clinically isolated syndrome patients with short (<60 months) and 11 with long (>60 months) disease duration underwent 7T MRI. Lesions were subsequently analyzed side-by-side with regard to morphology and visibility on T2* weighted, SWI, magnitude and SWI-filtered phase images.Results126 of 192 T2* weighted lesions (65.6%) were characterized by a phase alteration pattern, and hence could be differentiated on phase images. In detail, a significantly reduced proportion of lesions showing phase alterations was detectable in patients with longer disease duration (mean±SD 51±37%, range 0–100%) compared to patients with short disease duration (mean±SD 90±19.5%, range 50–100%, p = 0.003).ConclusionThis cross-sectional study identified different patterns of phase changes in lesions of MS patients with short and long standing disease. Longitudinal studies are warranted to prove that MR phase imaging is useful in determining the activity and the developmental stage of individual MS plaques.

Transcranial sonography of subcortical structures in patients with multiple sclerosis

“…Perhaps it will encourage the modification of therapeutic purposes. MRI examinations using sequences based on imaging sensitive to iron show a significant association of advanced form of the disease (SP) and the accumulation of iron in the subcortical white matter . More such modifications were found in patients with long disease.…”

Iron deposition quantification: Applications in the brain and liver

“…SWI phase has been used to visualize MS WM lesions in several studies . Earlier work noted the increase in iron deposition within the lesions and at their periphery, and this was confirmed in a subset of MS lesions seen in cadaver brain studies to be iron laden macrophages in ring like lesions .…”

Progressive Multifocal Leukoencephalopathy in a Multiple Sclerosis Patient Diagnosed after Switching from Natalizumab to Fingolimod

“…Thus, 7 T MRI has improved the detection and morphological characterization of neuroinflammatory brain lesions [21–23]. Most importantly, a small venous vessel is often detectable within the center of MS lesions by using gradient echo MR techniques at 7 T [24–28], facilitating the distinction to other CNS diseases such as neuromyelitis optica [29, 30] and Susac syndrome [31]. …”