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Mult Scler. 2013 Jul;19(8):1068-73. doi: 10.1177/1352458512471093. Epub 2012 Dec 17.

Initial investigation of the blood-brain barrier in MS lesions at 7 tesla.

Author information

1
Translational Neuroradiology Unit, Neuroimmunology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA.

Abstract

BACKGROUND:

We previously described two dynamics of contrast enhancement in scans of active multiple sclerosis lesions: Medium-sized, early lesions enhance centrifugally, whereas larger, slightly older lesions enhance centripetally. Due to technical limitations, our previous study did not characterize lesions < 5 mm in diameter, cortical enhancement, and anatomical structures within lesions.

OBJECTIVE:

The objective of this paper is to obtain initial observations of these important aspects of lesion development on a 7 tesla scanner at high spatial resolution.

METHODS:

We scanned eight patients, acquiring precontrast T2*-weighted scans, T1-weighted scans before and after contrast, and high-resolution dynamic contrast-enhanced scans during and up to 30 min after contrast.

RESULTS:

We detected 15 enhancing lesions, obtaining dynamic data in 10: Five lesions < 4 mm enhanced centrifugally (initial central enhancement expanded outward), and five lesions > 4 mm enhanced centripetally (initial peripheral enhancement gradually filled the lesion). A leukocortical lesion initially showed enhancement in its white matter portion, which gradually spread into the cortex. Seventy-three percent of lesions were clearly perivenular.

CONCLUSION:

Most active lesions are perivenular, and the smallest lesions enhance centrifugally. This supports the idea that lesions grow outward from a central vein.

KEYWORDS:

7 tesla; Veins; blood-brain barrier; contrast-enhancing lesions; magnetic resonance imaging; susceptibility weighted imaging

PMID:
23246799
PMCID:
PMC4744645
DOI:
10.1177/1352458512471093
[Indexed for MEDLINE]
Free PMC Article

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