Venous Diameter Changes in Chronic Active Multiple Sclerosis Lesions

Abstract

BACKGROUND AND PURPOSE: To investigate the temporal evolution of venous diameter in chronic active and nonenhancing shrinking multiple sclerosis (MS) lesions in a longitudinal magnetic resonance imaging (MRI) study including susceptibilityweighted images (SWI). METHODS: We compared the venous diameter in chronic active and nonenhancing shrinking lesions to the venous diameter in nonenhancing stable lesions on two 3 T MRI data sets obtained 12 months apart. Chronic active and nonenhancing shrinking lesions were identified by Voxel-Guided Morphometry. Coregistered, overlaid fluid-attenuated inversion recovery/SWI were analyzed for the presence of a central vein. Quantitative calculation of the venous diameter for each time point was performed on the reconstructed veins. RESULTS: Sixty-two relapsing-remitting MS patients (50 women; mean age: 36 ± 11 years; mean disease duration: 4 ± 7 years) were included in the study. Overall, we identified 222 chronic MS lesions (48 chronic active, 48 shrinking, 126 stable) with a corresponding intralesional central vein. On baseline MRI, the mean venous diameter did not statistically differ between all subgroups, whereas on follow-up MRI, the mean intralesional venous diameter was smaller in chronic active (0.92 ± 0.15 mm) and shrinking lesions (0.90 ± 0.19 mm) compared to stable lesions (1.10 ± 0.18 mm; P < .001). CONCLUSION: Our findings demonstrate venous narrowing in chronic active and nonenhancing shrinking MS lesions. The smaller diameter of intralesional veins during follow up in these lesions may reflect structural, degenerative, and metabolic changes due to chronic inflammation, (perivascular) fibrosis, collagenous thickening, and increased levels of oxygenated hemoglobin.

Association of iron rim lesions with brain and cervical cord volume in relapsing multiple sclerosis

“…Recently, there has been an increasing interest in "chronic active" MS lesions that are associated with higher disease severity and ongoing tissue destruction as an imaging biomarker of disease progression [3][4][5][6][7][8]. Histopathologically, chronic active lesions are characterised by a self-sustained low degree of chronic inflammation, active myelin breakdown, neurodegeneration, axonal loss, and progressive tissue matrix damage driven by a rim of iron-laden activated microglia/macrophages and reactive astrocytes at the lesion edge [4,9].…”

Iron Rim Lesions as a Specific and Prognostic Biomarker of Multiple Sclerosis: 3T-Based Susceptibility-Weighted Imaging

“…In a pathological survey on 2476 WMLs in MS, expanding lesions were predominantly found in progressive MS and were suggested to indicate progressive disease activity [20]. On the other hand, lesion shrinkage might be related to tissue repair and reduced inflammatory activity with the resolution of extracellular water as part of inflammatory edema [21]. Having lesions with IRLs would be associated with the active disease process and severity.…”

Associations of deep medullary veins with vascular risk factors, laboratory indicators, and cerebral small vessel disease: A population‐based study

“…We demonstrated that DMV scores decreased as hemoglobin levels increased, implying better continuity of DMVs. SWI is a blood‐oxygen‐dependent MR sequence that is sensitive to iron in the form of hemosiderin and deoxyhemoglobin (Weber et al., 2021). Through oxygen metabolism in brain tissue, hemoglobin in the blood is converted into deoxyhemoglobin.…”