FLAIR* to visualize veins in white matter lesions: A new tool for the diagnosis of multiple sclerosis?

Objective: To explore the potential of a post-processing technique combining FLAIR and T2* (FLAIR*) to distinguish between lesions caused by multiple sclerosis (MS) from cerebral small vessel disease (SVD) in a clinical setting.Methods: FLAIR and T2* head datasets acquired at 3T of 25 people with re...

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Publicado en:European Radiology Vol. 27; no. 10; pp. 4257 - 4264
Autores principales: Campion, T., Smith, R., Altmann, D., Brito, G., Turner, B., Evanson, J., George, I., Sati, P., Reich, D., Miquel, M., Schmierer, K., Smith, R J P, Altmann, D R, Brito, G C, Turner, B P, George, I C, Reich, D S, Miquel, M E
Formato: Journal Article
Publicado: Springer Nature Oct2017
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2017
      vid: 27
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      pub: Springer Nature
      place: New York, New York
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        atl: FLAIR* to visualize veins in white matter lesions: A new tool for the diagnosis of multiple sclerosis?
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          Campion, T.
          Smith, R.
          Altmann, D.
          Brito, G.
          Turner, B.
          Evanson, J.
          George, I.
          Sati, P.
          Reich, D.
          Miquel, M.
          Schmierer, K.
          Smith, R J P
          Altmann, D R
          Brito, G C
          Turner, B P
          George, I C
          Reich, D S
          Miquel, M E
        affil: Department of Medical Statistics , London School of Hygiene and Tropical Medicine , London UK
      sug:
        subj:
          Veins
          Brain
          Magnetic Resonance Imaging Methods
          Neuroradiography Methods
          Multiple Sclerosis Pathology
          Male
          Brain Pathology
          Aged
          Cerebral Small Vessel Diseases
          Adult
          Sensitivity and Specificity
          Cerebral Ischemia
          Middle Age
          Female
          Interview Guides
          Scales
          Aged: 65+ years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Objective: To explore the potential of a post-processing technique combining FLAIR and T2* (FLAIR*) to distinguish between lesions caused by multiple sclerosis (MS) from cerebral small vessel disease (SVD) in a clinical setting.Methods: FLAIR and T2* head datasets acquired at 3T of 25 people with relapsing MS (pwRMS) and ten with pwSVD were used. After post-processing, FLAIR* maps were used to determine the proportion of white matter lesions (WML) showing the 'vein in lesion' sign (VIL), a characteristic histopathological feature of MS plaques. Sensitivity and specificity of MS diagnosis were examined on the basis of >45% VIL+ and >60% VIL+ WML, and compared with current dissemination in space (DIS) MRI criteria.Results: All pwRMS had >45% VIL+ WML (range 58-100%) whilst in pwSVD the proportion of VIL+ WML was significantly lower (0-64%; mean 32±20%). Sensitivity based on >45% VIL+ was 100% and specificity 80% whilst with >60% VIL+ as the criterion, sensitivity was 96% and specificity 90%. DIS criteria had 96% sensitivity and 40% specificity.Conclusion: FLAIR* enables VIL+ WML detection in a clinical setting, facilitating differentiation of MS from SVD based on brain MRI.Key Points: • FLAIR* in a clinical setting allows visualization of veins in white matter lesions. • Significant proportions of MS lesions demonstrate a vein in lesion on MRI. • Microangiopathic lesions demonstrate a lower proportion of intralesional veins than MS lesions. • Intralesional vein-based criteria may complement current MRI criteria for MS diagnosis.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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