Z Hosseini1,2, J Matusinec3, D A Rudko4,5, J Liu2, B Y M Kwan6, F Salehi6, M Sharma6,7, M Kremenchutzky7, R S Menon1,2,8, M Drangova9,2,8. 1. From the Biomedical Engineering Graduate Program (Z.H., R.S.M., M.D.). 2. Imaging Research Laboratories (Z.H., J.L., R.S.M., M.D.), Robarts Research Institute. 3. Departments of Medicine (J.M.). 4. Department of Neurology and Neurosurgery (D.A.R.), McConnell Brain Imaging Centre, Montreal Neurological Institute. 5. Department of Biomedical Engineering (D.A.R.), McGill University, Montreal, Quebec, Canada. 6. Medical Imaging (B.Y.M.K., F.S., M.S.). 7. Department of Clinical Neurological Sciences (M.S., M.K.), Western University and London Health Sciences Centre, London, Ontario, Canada. 8. Medical Biophysics (R.S.M., M.D.), Schulich School of Medicine and Dentistry; Western University, London, Ontario, Canada. 9. From the Biomedical Engineering Graduate Program (Z.H., R.S.M., M.D.) mdrangova@robarts.ca.
Abstract
BACKGROUND AND PURPOSE: Recently published North American Imaging in Multiple Sclerosis guidelines call for derivation of a specific radiologic definition of MS WM lesions and mimics. The purpose of this study was to use SWI and magnetization-prepared FLAIR images for sensitive differentiation of MS from benign WM lesions using the morphologic characteristics of WM lesions. MATERIALS AND METHODS: Seventeen patients with relapsing-remitting MS and 18 healthy control subjects were enrolled retrospectively. For each subject, FLAIR and multiecho gradient-echo images were acquired using 7T MR imaging. Optimized postprocessing was used to generate single-slice SWI of cerebral veins. SWI/FLAIR images were registered, and 3 trained readers performed lesion assessment. Morphology, location of lesions, and the time required for assessment were recorded. Analyses were performed on 3 different pools: 1) lesions of >3 mm, 2) nonconfluent lesions of >3 mm, and 3) nonconfluent lesions of >3 mm with no or a single central vein. RESULTS: The SWI/FLAIR acquisition and processing protocol enabled effective assessment of central veins and hypointense rims in WM lesions. Assessment of nonconfluent lesions with ≥1 central vein enabled the most specific and sensitive differentiation of patients with MS from controls. A threshold of 67% perivenous WM lesions separated patients with MS from controls with a sensitivity of 94% and specificity of 100%. Lesion assessment took an average of 12 minutes 10 seconds and 4 minutes 33 seconds for patients with MS and control subjects, respectively. CONCLUSIONS: Nonconfluent lesions of >3 mm with ≥1 central vein were the most sensitive and specific differentiators between patients with MS and control subjects.
BACKGROUND AND PURPOSE: Recently published North American Imaging in Multiple Sclerosis guidelines call for derivation of a specific radiologic definition of MS WM lesions and mimics. The purpose of this study was to use SWI and magnetization-prepared FLAIR images for sensitive differentiation of MS from benign WM lesions using the morphologic characteristics of WM lesions. MATERIALS AND METHODS: Seventeen patients with relapsing-remitting MS and 18 healthy control subjects were enrolled retrospectively. For each subject, FLAIR and multiecho gradient-echo images were acquired using 7T MR imaging. Optimized postprocessing was used to generate single-slice SWI of cerebral veins. SWI/FLAIR images were registered, and 3 trained readers performed lesion assessment. Morphology, location of lesions, and the time required for assessment were recorded. Analyses were performed on 3 different pools: 1) lesions of >3 mm, 2) nonconfluent lesions of >3 mm, and 3) nonconfluent lesions of >3 mm with no or a single central vein. RESULTS: The SWI/FLAIR acquisition and processing protocol enabled effective assessment of central veins and hypointense rims in WM lesions. Assessment of nonconfluent lesions with ≥1 central vein enabled the most specific and sensitive differentiation of patients with MS from controls. A threshold of 67% perivenous WM lesions separated patients with MS from controls with a sensitivity of 94% and specificity of 100%. Lesion assessment took an average of 12 minutes 10 seconds and 4 minutes 33 seconds for patients with MS and control subjects, respectively. CONCLUSIONS: Nonconfluent lesions of >3 mm with ≥1 central vein were the most sensitive and specific differentiators between patients with MS and control subjects.
Authors: M A Clarke; D Pareto; L Pessini-Ferreira; G Arrambide; M Alberich; F Crescenzo; S Cappelle; M Tintoré; J Sastre-Garriga; C Auger; X Montalban; N Evangelou; À Rovira Journal: AJNR Am J Neuroradiol Date: 2020-05-21 Impact factor: 3.825
Authors: Ambica Mehndiratta; Constantina A Treaba; Valeria Barletta; Elena Herranz; Russell Ouellette; Jacob A Sloane; Eric C Klawiter; Revere P Kinkel; Caterina Mainero Journal: Mult Scler Date: 2020-06-25 Impact factor: 6.312
Authors: S Suthiphosuwan; P Sati; M Guenette; X Montalban; D S Reich; A Bharatha; J Oh Journal: AJNR Am J Neuroradiol Date: 2019-04-18 Impact factor: 3.825
Authors: Elisabeth Sartoretti; Thomas Sartoretti; Michael Wyss; Anton S Becker; Árpád Schwenk; Luuk van Smoorenburg; Arash Najafi; Christoph Binkert; Harriet C Thoeny; Jinyuan Zhou; Shanshan Jiang; Nicole Graf; David Czell; Sabine Sartoretti-Schefer; Carolin Reischauer Journal: Front Neurol Date: 2019-12-10 Impact factor: 4.003