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Mult Scler. 2016 Sep;22(10):1289-96. doi: 10.1177/1352458515616700. Epub 2015 Dec 10.

Imaging central veins in brain lesions with 3-T T2*-weighted magnetic resonance imaging differentiates multiple sclerosis from microangiopathic brain lesions.

Author information

1
Department of Neurology, Nottingham University Hospitals NHS Trust, Nottingham, UK.
2
Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.
3
Sir Peter Mansfield Magnetic Resonance Centre, University of Nottingham, Nottingham, UK.
4
Department of Neurology, University Hospital of Wales, Cardiff, UK.
5
Department of Radiology, Nottingham University Hospitals NHS Trust, Nottingham, UK.
6
Department of Medical Physics, Nottingham University Hospitals NHS Trust, Nottingham, UK.
7
Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK nikos.evangelou@nottingham.ac.uk.

Abstract

BACKGROUND:

White matter lesions are frequently detected using brain magnetic resonance imaging (MRI) performed for various indications. Most are microangiopathic, but demyelination, including multiple sclerosis (MS), is an important cause; conventional MRI cannot always distinguish between these pathologies. The proportion of lesions with a central vein on 7-T T2*-weighted MRI prospectively distinguishes demyelination from microangiopathic lesions.

OBJECTIVE:

To test whether 3-T T2*-weighted MRI can differentiate MS from microangiopathic brain lesions.

METHODS:

A total of 40 patients were studied. Initially, a test cohort of 10 patients with MS and 10 patients with microangiopathic white matter lesions underwent 3-T T2*-weighted brain MRI. Anonymised scans were analysed blind to clinical data, and simple diagnostic rules were devised. These rules were applied to a validation cohort of 20 patients (13 with MS and 7 with microangiopathic lesions) by a blinded observer.

RESULTS:

Within the test cohort, all patients with MS had central veins visible in >45% of brain lesions, while the rest had central veins visible in <45% of lesions. By applying diagnostic rules to the validation cohort, all remaining patients were correctly categorised.

CONCLUSION:

3-T T2*-weighted brain MRI distinguishes perivenous MS lesions from microangiopathic lesions. Clinical application of this technique could supplement existing diagnostic algorithms.

KEYWORDS:

Multiple sclerosis; diagnosis; magnetic resonance imaging; sensitivity and specificity

PMID:
26658816
DOI:
10.1177/1352458515616700
[Indexed for MEDLINE]

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