Catarina Pinto1,2, Melissa Cambron3, Adrienn Dobai4,5, Eva Vanheule2,6, Jan W Casselman7,8,9. 1. Neuroradiology Department, Centro Hospitalar Universitário Do Porto, Porto, Portugal. 2. Department of Radiology, AZ St. Jan Brugge-Oostende av, Campus Brugge, Ruddershove 10, B-8000, Brugge, Belgium. 3. Department of Neurology, AZ St. Jan Brugge-Oostende av, Campus Brugge, Ruddershove 10, B-8000, Brugge, Belgium. 4. Department of Oral Diagnostics, Faculty of Dentistry, Semmelweis University, Szentkirályi u. 47, Budapest, 1088, Hungary. 5. Department of Neuroradiology, Medical Imaging Centre, Semmelweis University, Balassa street 6, Budapest, 1083, Hungary. 6. Department of Radiology, UZ-Gent, Gent, Belgium. 7. Department of Radiology, AZ St. Jan Brugge-Oostende av, Campus Brugge, Ruddershove 10, B-8000, Brugge, Belgium. jan.casselman@azsintjan.be. 8. University Ghent, Gent, Belgium. jan.casselman@azsintjan.be. 9. Department of Radiology, AZ St. Augustinus, Oosterveldlaan 24, B-2610, Antwerpen, Belgium. jan.casselman@azsintjan.be.
Abstract
PURPOSE: In multiple sclerosis (MS), chronic active/smoldering white matter lesions presenting with hypointense rims on susceptibility-weighted imaging (SWI) of the brain have been recognized as an important radiological feature. The aim of this work was to study the prevalence of paramagnetic rim lesions (RLs) in MS patients in a clinical setting and to assess differences in demographic and clinical variables regarding the presence of RLs. METHODS: All 3 T brain magnetic resonance (MR) studies performed in MS patients between July 2020 and January 2021 were reviewed. In all patients, RLs were assessed on three-dimensional (3D) SWI images and the T2 FLAIR lesion load volume was assessed. Demographic, laboratory (oligoclonal bands in CSF), and clinical data, including functional status with Expanded Disability Status Scale (EDSS), were retrieved from the clinical files. RESULTS: Of the 192 patients, 113 (59%) presented with at least 1 RL. In the RL-positive group, the mean RL count was 4.81 ranging from 1 to 37. There was no significant difference in the number of RLs between the different types of MS (p = 0.858). Regarding the presence of RLs, there were no significant differences based on gender (p = 0.083), disease duration (p = 0.520), treatment regime (p = 0.326), EDSS score (p = 0.103), and the associated T2 FLAIR lesion load volume. CONCLUSION: SWI RLs were frequently detected in our cohort regardless of the MS type, T2 FLAIR lesion load volume, demographic features, disease duration, or clinical score. Our results suggest that RLs are not associated with more severe forms of the disease. Today, RLs can be seen on 3 T 3D SWI, although this is not a clinical standard sequence yet. Therefore, it should be considered an additional helpful MR sequence in the diagnostic workup of MS, although more studies are warranted to establish the role of RLs as prognostic markers.
PURPOSE: In multiple sclerosis (MS), chronic active/smoldering white matter lesions presenting with hypointense rims on susceptibility-weighted imaging (SWI) of the brain have been recognized as an important radiological feature. The aim of this work was to study the prevalence of paramagnetic rim lesions (RLs) in MS patients in a clinical setting and to assess differences in demographic and clinical variables regarding the presence of RLs. METHODS: All 3 T brain magnetic resonance (MR) studies performed in MS patients between July 2020 and January 2021 were reviewed. In all patients, RLs were assessed on three-dimensional (3D) SWI images and the T2 FLAIR lesion load volume was assessed. Demographic, laboratory (oligoclonal bands in CSF), and clinical data, including functional status with Expanded Disability Status Scale (EDSS), were retrieved from the clinical files. RESULTS: Of the 192 patients, 113 (59%) presented with at least 1 RL. In the RL-positive group, the mean RL count was 4.81 ranging from 1 to 37. There was no significant difference in the number of RLs between the different types of MS (p = 0.858). Regarding the presence of RLs, there were no significant differences based on gender (p = 0.083), disease duration (p = 0.520), treatment regime (p = 0.326), EDSS score (p = 0.103), and the associated T2 FLAIR lesion load volume. CONCLUSION: SWI RLs were frequently detected in our cohort regardless of the MS type, T2 FLAIR lesion load volume, demographic features, disease duration, or clinical score. Our results suggest that RLs are not associated with more severe forms of the disease. Today, RLs can be seen on 3 T 3D SWI, although this is not a clinical standard sequence yet. Therefore, it should be considered an additional helpful MR sequence in the diagnostic workup of MS, although more studies are warranted to establish the role of RLs as prognostic markers.
Authors: S Chawla; I Kister; J Wuerfel; J-C Brisset; S Liu; T Sinnecker; P Dusek; E M Haacke; F Paul; Y Ge Journal: AJNR Am J Neuroradiol Date: 2016-03-24 Impact factor: 3.825
Authors: Martina Absinta; Pascal Sati; María I Gaitán; Pietro Maggi; Irene C M Cortese; Massimo Filippi; Daniel S Reich Journal: Ann Neurol Date: 2013-09-16 Impact factor: 10.422
Authors: Josa M Frischer; Stephen D Weigand; Yong Guo; Nilufer Kale; Joseph E Parisi; Istvan Pirko; Jay Mandrekar; Stephan Bramow; Imke Metz; Wolfgang Brück; Hans Lassmann; Claudia F Lucchinetti Journal: Ann Neurol Date: 2015-08-24 Impact factor: 10.422
Authors: Margareta A Clarke; Amal Pr Samaraweera; Yasser Falah; Alain Pitiot; Christopher M Allen; Robert A Dineen; Chris R Tench; Paul S Morgan; Nikos Evangelou Journal: Mult Scler Date: 2019-10-31 Impact factor: 6.312
Authors: Assunta Dal-Bianco; Günther Grabner; Claudia Kronnerwetter; Michael Weber; Romana Höftberger; Thomas Berger; Eduard Auff; Fritz Leutmezer; Siegfried Trattnig; Hans Lassmann; Francesca Bagnato; Simon Hametner Journal: Acta Neuropathol Date: 2016-10-27 Impact factor: 17.088
Authors: Massimo Filippi; Paolo Preziosa; Brenda L Banwell; Frederik Barkhof; Olga Ciccarelli; Nicola De Stefano; Jeroen J G Geurts; Friedemann Paul; Daniel S Reich; Ahmed T Toosy; Anthony Traboulsee; Mike P Wattjes; Tarek A Yousry; Achim Gass; Catherine Lubetzki; Brian G Weinshenker; Maria A Rocca Journal: Brain Date: 2019-07-01 Impact factor: 13.501