Temporal evolution of acute multiple sclerosis lesions on serial sodium (23Na) MRI

Eisele, Philipp; Konstandin, Simon; Szabo, Kristina; Ebert, Anne; Roßmanith, Christina; Paschke, Nadia; Kerschensteiner, Martin; Platten, Michael; Schoenberg, Stefan O.; Schad, Lothar R.; Gass, Achim

doi:10.1016/j.msard.2019.01.027

Cited by 23 publications

(30 citation statements)

References 32 publications

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“…23 Na MRI can support the evaluation of treatment response especially concerning the neurodegenerative component. Additionally, recent studies indicate that 23 Na MRI could be used to monitor inflammatory processes …”

Section: Physiologymentioning

confidence: 99%

X‐nuclei imaging: Current state, technical challenges, and future directions

Kleimaier

Malzacher

et al. 2019

Magnetic Resonance Imaging

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1H imaging is concerned with contrast generation among anatomically distinct soft tissues. X‐nuclei imaging, on the other hand, aims to reveal the underlying changes in the physiological processes on a cellular level. Advanced clinical MR hardware systems improved 1H image quality and simultaneously enabled X‐nuclei imaging. Adaptation of 1H methods and optimization of both sequence design and postprocessing protocols launched X‐nuclei imaging past feasibility studies and into clinical studies. This review outlines the current state of X‐nuclei MRI, with the focus on 23Na, 35Cl, 39K, and 17O. Currently, various aspects of technical challenges limit the possibilities of clinical X‐nuclei MRI applications. To address these challenges, quintessential physical and technical concepts behind different applications are presented, and the advantages and drawbacks are delineated. The working process for methods such as quantification and multiquantum imaging is shown step‐by‐step. Clinical examples are provided to underline the potential value of X‐nuclei imaging in multifaceted areas of application. In conclusion, the scope of the latest technical advance is outlined, and suggestions to overcome the most fundamental hurdles on the way into clinical routine by leveraging the full potential of X‐nuclei imaging are presented. Level of Evidence: 1 Technical Efficacy Stage: 3 J. Magn. Reson. Imaging 2020;51:355–376.

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Section: Physiologymentioning

confidence: 99%

X‐nuclei imaging: Current state, technical challenges, and future directions

Kleimaier

Malzacher

et al. 2019

Magnetic Resonance Imaging

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“…New T2 lesions on follow-up MRI are commonly employed in the search for a recent inflammatory disease activity. In addition, the presence of contrast enhancement on post-contrast T1-weighted (T1w) images and occasionally hyperintensity on diffusion weighted MRI can also indicate acute inflammatory changes (2–5). Recently, susceptibility-weighted imaging (SWI), a velocity-compensated three-dimensional gradient echo sequence (6), has been shown to be sensitive to iron on the form of ferritin, hemosiderin, and deoxyhemoglobin (7).…”

Section: Introductionmentioning

confidence: 99%

Characterization of Contrast-Enhancing and Non-contrast-enhancing Multiple Sclerosis Lesions Using Susceptibility-Weighted Imaging

et al. 2019

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Susceptibility-weighted magnetic resonance imaging (MRI) (SWI) offers additional information on conventional MRI contrasts. Central veins can be identified within lesions, and recently, it has been suggested that multiple sclerosis (MS) lesions with slowly expanding demyelination, so-called smoldering lesions, can be identified by a phase rim surrounding the lesion. We analyzed post-contrast SWI in regard to intrinsic lesion characteristics in a cohort of MS patients. A total of 294 MS patients were evaluated using a 3-T MRI. A comprehensive MRI protocol was used including post-contrast SWI. Lesions of at least 5 mm in size were analyzed on conventional MRI and SWI with a structured reporting scheme with a focus on SWI lesion characteristics. A total of 1,323 lesions were analyzed: 1,246/1,323 (94%) were non-enhancing and 77/1,323 (6%) were contrast-enhancing (CE) lesions. In CE lesions, the following patterns were seen: contrast enhancement was nodular in 34/77, ring-shaped enhancement was present in 33/77, and areas of peripheral enhancement were present in 10/77. In CE lesions, an association with central veins was found in 38/77 (50%). In 75/1,246 (6%) non-enhancing lesions, a central dark dot in keeping with a central vein was seen, whereas 162/1,246 (13%) showed peripheral hypointense dots/rims, 199/1,246 (16%) showed scattered hypointense dots mainly within the lesion area, and in 374/1,246 (30%), no SWI hypointensity was detected. Furthermore, 436/1,246 (35%) lesions showed isointensity to the surrounding tissue and were not visible on SWI. SWI is able to offer additional aspects of MS pathology also when used after the application of a contrast agent. Veins connected to lesions, a potentially useful marker in the differential diagnosis of MS, were seen in about 50% of enhancing lesions. Susceptibility artifacts, suggested to mark the presence of myelin-laden macrophages and smoldering inflammation, were visible in 28% of lesions as hypointense dots in and in the periphery of the lesion. Given those results, SWI may provide practical useful additional information in the evaluation of the lesion status in MS patients.

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“…In white matter the tissue volume is dominated by the densely packed glial cells while the extracellular space accounts for no more than 6-20% of the total volume (23), giving sodium a tissue equivalent concentration of approximately 18-36 mM (4,7,8). In age-related white matter changes where localized lacunar infarction or diffuse alterations are detected (24) and usually associated with cognitive impairment (25).…”

Section: Discussionmentioning

confidence: 99%

“…Sodium ( 23 Na) MRI is a promising non-invasive imaging technique that might reflect the severity of tissue disintegration and has recently been applied in several pathologies including acute ischemic stroke (7), multiple sclerosis (8), and cerebral neoplasms (9). Thus, it may serve as a disease progression marker.…”

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confidence: 99%

Evaluation of Sodium (²³Na) MR-imaging as a Biomarker and Predictor for Neurodegenerative Changes in Patients With Alzheimer’s Disease

Mohamed

Herrmann

Adlung

et al. 2021

In Vivo

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Temporal evolution of acute multiple sclerosis lesions on serial sodium (23Na) MRI

Cited by 23 publications

References 32 publications

X‐nuclei imaging: Current state, technical challenges, and future directions

X‐nuclei imaging: Current state, technical challenges, and future directions

Characterization of Contrast-Enhancing and Non-contrast-enhancing Multiple Sclerosis Lesions Using Susceptibility-Weighted Imaging

Evaluation of Sodium (²³Na) MR-imaging as a Biomarker and Predictor for Neurodegenerative Changes in Patients With Alzheimer’s Disease

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Temporal evolution of acute multiple sclerosis lesions on serial sodium (23Na) MRI

Cited by 23 publications

References 32 publications

X‐nuclei imaging: Current state, technical challenges, and future directions

X‐nuclei imaging: Current state, technical challenges, and future directions

Characterization of Contrast-Enhancing and Non-contrast-enhancing Multiple Sclerosis Lesions Using Susceptibility-Weighted Imaging

Evaluation of Sodium (23Na) MR-imaging as a Biomarker and Predictor for Neurodegenerative Changes in Patients With Alzheimer’s Disease

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Evaluation of Sodium (²³Na) MR-imaging as a Biomarker and Predictor for Neurodegenerative Changes in Patients With Alzheimer’s Disease