Neuromyelitis optica does not impact periventricular venous density versus healthy controls: a 7.0 Tesla MRI clinical study

Abstract

Object:To quantify the periventricular venous density in neuromyelitis optica spectrum disease (NMOSD) in comparison to multiple sclerosis (MS) and healthy control subjects. Materials and Methods:Sixteen NMOSD, sixteen MS and sixteen healthy control subjects (HC) underwent 7.0 Tesla (7T) MRI. The imaging protocol included T 2 * weighted (T2*w) fast low angle shot (FLASH) and fluid attenuated inversion recovery (FLAIR) sequences. The periventricular venous area (PVA) was manually determined by a blinded investigator in order to estimate the periventricular venous density in a region-of-interest based approach. Results:No significant differences in periventricular venous density indicated by PVA were detectable in NMOSD versus healthy controls (p=0.226). In contrast, PVA was significantly reduced in MS patients compared to HC (p=0.013). Conclusion:Unlike in MS, patients suffering from NMOSD did not show a reduced venous visibility.This finding may underscore primary and secondary pathophysiological differences between these two distinct diseases of the central nervous system. 5

Value of the central vein sign at 3T to differentiate MS from seropositive NMOSD

“…In line with previous studies, 7,18 when lesions were classified according to their location, MS lesions demonstrated the CVS more frequently in deep white mater than NMOSD lesions, which were more likely to show the CVS in the periventricular location. This is also in agreement with the previous report of reduced periventricular venous visibility in MS than NMOSD, as a consequence of more extensive brain parenchymal gliosis in MS. 26 From a clinical perspective, we hypothesize that the practical utility of the CVS is that its absence at the onset of optic neuritis or transverse myelitis would support a diagnosis of seropositive NMOSD, but this needs to be tested and validated in studies including patients with seropositive and seronegative NMOSD and patients at an early stage of their disease, when the number of lesions may be low, therefore reducing the discriminatory value of the CVS.…”

Quantitative 7T MRI does not detect occult brain damage in neuromyelitis optica

“…Finally, a 7T MRI study on the periventricular venous density in patients with NMOSD did not report changes in venous visibility on highly resolving T2*w images arguing against a widespread hypometabolism in NMOSD. 36…”

Ultra-high-field 7-T MRI in multiple sclerosis and other demyelinating diseases: from pathology to clinical practice

“…The use of susceptibility-weighted imaging-filtered phase images has further allowed to characterise lesion morphology both in MS and NMOSD, confirming that in the latter a paramagnetic phase change, in rim-like or nodular fashion, is virtually absent compared to MS (2%) [72]. Interestingly, a reduced periventricular venous density has been demonstrated in MS but not in NMOSD, showing that the reduced proportion of lesion containing a venule is not attributable to a minor venous representation in the latter [73]. The use of quantitative susceptibility mapping has allowed to identify additional morphological differences in iron deposition in the lesions of the two conditions [74] (Fig.…”