Quantification of Blood-Brain-Barrier Permeability Dysregulation and Inflammatory Activity in MS Lesions by

Mohammad Ali Oghabian1, Asieh Fatemidokht2, Mohammad Hossein Haririchian3

  • 1Department of Neuroimaging and Analysis, Research Center for Cellular and Molecular Imaging, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

Insights

Blood-brain barrier permeability is impaired in Multiple Sclerosis (MS) lesions. Dynamic contrast-enhanced MRI reveals higher permeability in contrast-enhanced lesions, indicating active inflammation in MS.

Area of Science:

  • Radiology
  • Neuroscience
  • Immunology

Background:

  • Blood-brain barrier (BBB) perfusion is often impaired in Multiple Sclerosis (MS).
  • Quantitative analysis of perfusion parameters in contrast-enhanced (CE) versus non-enhanced (NE) MS lesions is not well-documented.
  • Dynamic contrast-enhanced (DCE) MRI provides pharmacokinetic parameters to quantify BBB permeability leakage.

Purpose of the Study:

  • To compare perfusion parameters between CE and NE lesions in patients with Relapsing-remitting MS (RRMS).
  • To assess the utility of Ktrans as a marker for BBB permeability impairment and inflammation in MS lesions.

Main Methods:

  • MR examination of 28 RRMS patients with multiple brain lesions.
  • Acquisition of 3D dynamic T1-weighted spoiled gradient echo sequences.
  • Analysis of perfusion parameters (Ktrans, Kep, Vb) using the Extended Toft model in enhanced and non-enhanced lesions and normal appearing white matter (NAWM).

Main Results:

  • Significantly higher Ktrans values were observed in CE lesions compared to NE lesions.
  • Significant differences in Ktrans and Kep were found between CE lesions, NE lesions, and NAWM.
  • Vb showed only slight differences between NE and CE lesions.

Conclusions:

  • Ktrans is a valuable parameter for demonstrating BBB permeability impairment in CE MS lesions.
  • BBB dysregulation in CE lesions is indicative of active inflammation in MS.