S Coulette1, A Lecler2, E Saragoussi2, K Zuber3, J Savatovsky2, R Deschamps1, O Gout1, C Sabben1, J Aboab1, A Affortit4, F Charbonneau2, M Obadia5. 1. From the Neurology Department (S.C., R.D., O.G., C.S., J.A., M.O.). 2. Neuroradiology Department (A.L.. E.S., J.S., F.C.). 3. Clinical Research Unit (K.Z.). 4. Ophthalmology Department (A.A.), Fondation Ophtalmologique Adolphe de Rothschild, Paris, France. 5. From the Neurology Department (S.C., R.D., O.G., C.S., J.A., M.O.) mobadia@for.paris.
Abstract
BACKGROUND AND PURPOSE: Leptomeningeal enhancement can be found in a variety of neurologic diseases such as Susac Syndrome. Our aim was to assess its prevalence and significance of leptomeningeal enhancement in Susac syndrome using 3T postcontrast fluid-attenuated inversion recovery MR imaging. MATERIALS AND METHODS: From January 2011 to December 2017, nine consecutive patients with Susac syndrome and a control group of 73 patients with multiple sclerosis or clinically isolated syndrome were included. Two neuroradiologists blinded to the clinical and ophthalmologic data independently reviewed MRIs and assessed leptomeningeal enhancement and parenchymal abnormalities. Follow-up MRIs (5.9 MRIs is the mean number per patient over a median period of 46 months) of patients with Susac syndrome were reviewed and compared with clinical and retinal fluorescein angiographic data evaluated by an independent ophthalmologist. Fisher tests were used to compare the 2 groups, and mixed-effects logistic models were used for analysis of clinical and imaging follow-up of patients with Susac syndrome. RESULTS: Patients with Susac syndrome were significantly more likely to present with leptomeningeal enhancement: 5/9 (56%) versus 6/73 (8%) in the control group (P = .002). They had a significantly higher leptomeningeal enhancement burden with ≥3 lesions in 5/9 patients versus 0/73 (P < .001). Regions of leptomeningeal enhancement were significantly more likely to be located in the posterior fossa: 5/9 versus 0/73 (P < .001). Interobserver agreement for leptomeningeal enhancement was good (κ = 0.79). There was a significant association between clinical relapses and increase of both leptomeningeal enhancement and parenchymal lesion load: OR = 6.15 (P = .01) and OR = 5 (P = .02), respectively. CONCLUSIONS: Leptomeningeal enhancement occurs frequently in Susac syndrome and could be helpful for diagnosis and in predicting clinical relapse.
BACKGROUND AND PURPOSE: Leptomeningeal enhancement can be found in a variety of neurologic diseases such as Susac Syndrome. Our aim was to assess its prevalence and significance of leptomeningeal enhancement in Susac syndrome using 3T postcontrast fluid-attenuated inversion recovery MR imaging. MATERIALS AND METHODS: From January 2011 to December 2017, nine consecutive patients with Susac syndrome and a control group of 73 patients with multiple sclerosis or clinically isolated syndrome were included. Two neuroradiologists blinded to the clinical and ophthalmologic data independently reviewed MRIs and assessed leptomeningeal enhancement and parenchymal abnormalities. Follow-up MRIs (5.9 MRIs is the mean number per patient over a median period of 46 months) of patients with Susac syndrome were reviewed and compared with clinical and retinal fluorescein angiographic data evaluated by an independent ophthalmologist. Fisher tests were used to compare the 2 groups, and mixed-effects logistic models were used for analysis of clinical and imaging follow-up of patients with Susac syndrome. RESULTS:Patients with Susac syndrome were significantly more likely to present with leptomeningeal enhancement: 5/9 (56%) versus 6/73 (8%) in the control group (P = .002). They had a significantly higher leptomeningeal enhancement burden with ≥3 lesions in 5/9 patients versus 0/73 (P < .001). Regions of leptomeningeal enhancement were significantly more likely to be located in the posterior fossa: 5/9 versus 0/73 (P < .001). Interobserver agreement for leptomeningeal enhancement was good (κ = 0.79). There was a significant association between clinical relapses and increase of both leptomeningeal enhancement and parenchymal lesion load: OR = 6.15 (P = .01) and OR = 5 (P = .02), respectively. CONCLUSIONS: Leptomeningeal enhancement occurs frequently in Susac syndrome and could be helpful for diagnosis and in predicting clinical relapse.
Authors: Katherine A Buzzard; Stephen W Reddel; Con Yiannikas; D Sean Riminton; Michael H Barnett; Todd A Hardy Journal: J Neurol Date: 2014-12-30 Impact factor: 4.849
Authors: T Papo; V Biousse; P Lehoang; C Fardeau; N N'Guyen; D L Huong; O Aumaitre; M G Bousser; P Godeau; J C Piette Journal: Medicine (Baltimore) Date: 1998-01 Impact factor: 1.889
Authors: Todd A Hardy; Billy O'Brien; Natasha Gerbis; Michael H Barnett; Stephen W Reddel; Janice Brewer; Geoffrey K Herkes; Paul Silberstein; Roger J Garsia; John D G Watson; Ruta Gupta; John D E Parratt; Michael E Buckland Journal: J Neurol Neurosurg Psychiatry Date: 2014-08-28 Impact factor: 10.154
Authors: R Zivadinov; D P Ramasamy; J Hagemeier; C Kolb; N Bergsland; F Schweser; M G Dwyer; B Weinstock-Guttman; D Hojnacki Journal: AJNR Am J Neuroradiol Date: 2018-02-08 Impact factor: 3.825
Authors: Lawrence L Latour; Dong-Wha Kang; Mustapha A Ezzeddine; Julio A Chalela; Steven Warach Journal: Ann Neurol Date: 2004-10 Impact factor: 10.422
Authors: James D Triplett; Jessica Qiu; Billy O'Brien; Sumana Gopinath; Benjamin Trewin; Penelope J Spring; Mohamed Shaffi; Jerome Ip; Fiona Chan; Luke Chen; Ian Wilson; Claire Muller; Heidi N Beadnall; Mike Boggild; Anneke Van der Walt; Richard Roxburgh; Nabil Seery; Tomas Kalincik; Michael H Barnett; John D E Parratt; Stephen W Reddel; Benjamin Tsang; Todd A Hardy Journal: Eur J Neurol Date: 2022-03-25 Impact factor: 6.288
Authors: Whitney M Freeze; Merel van der Thiel; Jeroen de Bresser; Catharina J M Klijn; Ellis S van Etten; Jacobus F A Jansen; Louise van der Weerd; Heidi I L Jacobs; Walter H Backes; Susanne J van Veluw Journal: Neuroimage Clin Date: 2020-10-02 Impact factor: 4.881