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Brain Magnetic Susceptibility Changes in Patients with Natalizumab-Associated Progressive Multifocal
J Hodel1, O Outteryck2, S Verclytte3
1From the University of Lille, CHU Lille (J.H., O.O., V.D., A.L., J.-P.P., P.V., X.L.), Lille, France Departments of Neuroradiology (J.H., J.-P.P., X.L.) Jerome.hodel@gmail.com.
AJNR. American Journal of Neuroradiology
|August 29, 2015
Summary
Brain magnetic susceptibility changes, detected using T2* and SWI MRI sequences, are a reliable indicator for diagnosing progressive multifocal leukoencephalopathy (PML), even in asymptomatic cases.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Progressive multifocal leukoencephalopathy (PML) is a serious opportunistic infection affecting the brain.
- Natalizumab, a treatment for multiple sclerosis (MS), is associated with an increased risk of PML.
- Accurate and early diagnosis of PML is crucial for patient management.
Purpose of the Study:
- To investigate brain magnetic susceptibility changes in patients with natalizumab-associated PML.
- To assess the utility of T2* and SWI MRI sequences in detecting these changes.
- To evaluate the diagnostic potential of magnetic susceptibility alterations for PML.
Main Methods:
- Retrospective analysis of 12 patients with natalizumab-associated PML, 5 with PML from other causes, and 55 with MS without PML.
- MR imaging including T2* or SWI sequences was performed.
- Signal abnormalities (low signal intensity) in the cortex, U-fibers, and basal ganglia were analyzed.
Main Results:
- All patients with PML showed T2* or SWI signal abnormalities at the chronic stage.
- No signal abnormalities were detected in patients without PML.
- Susceptibility changes were observed in 75% of asymptomatic natalizumab-PML cases, with basal ganglia systematically appearing hypointense.
Conclusions:
- Brain magnetic susceptibility changes, likely due to increased iron deposition, are consistently present in PML.
- T2* and SWI MRI sequences are effective in identifying these susceptibility alterations.
- Magnetic susceptibility changes represent a valuable diagnostic tool for progressive multifocal leukoencephalopathy.
