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Published on: June 26, 2013
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Multiparametric Characterization and Spatial Distribution of Different MS Lesion Phenotypes
Francesco Tazza1, Giacomo Boffa1, Simona Schiavi1
1From the Departments of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (F.T., G.B., S.S., E.C., M.I., M.C.), University of Genoa, Genoa, Italy.
AJNR. American Journal of Neuroradiology
|May 30, 2024
Summary
Quantitative susceptibility mapping and susceptibility mapping-weighted imaging classify multiple sclerosis lesions by phenotype. More severe lesions, like paramagnetic rim lesions, indicate greater damage and are linked to a worse disease course.
Area of Science:
- Neuroimaging
- Radiology
- Biomedical Engineering
Background:
- Multiple sclerosis (MS) lesions show varied axonal and myelin damage.
- Understanding lesion phenotypes aids evaluation of smoldering inflammation and remyelination.
- Distinct lesion characterization is crucial for MS progression assessment.
Purpose of the Study:
- Identify distinct MS lesion types in vivo using quantitative susceptibility mapping (QSM) and susceptibility mapping-weighted imaging (SWI).
- Characterize these phenotypes using T1-relaxometry, myelin mapping, and diffusion MRI.
- Investigate lesion distribution relative to the ventricular cerebrospinal fluid (CSF).
Main Methods:
- Categorized 53 individuals' MS lesions into iso/hypointense, hyperintense, and paramagnetic rim types using QSM and SWI.
- Compared susceptibility values, T1-relaxation times, myelin/free water fractions, and intracellular volume fraction among phenotypes.
- Calculated lesion distance from the ventricular CSF.
Main Results:
- SWI revealed microvasculature, refining lesion categorization (35.6% fewer paramagnetic rim, 22.5% fewer hyperintense lesions).
- Final categorization: 44.4% iso/hypointense, 47.9% hyperintense, 7.7% paramagnetic rim lesions.
- Observed a gradient of increasing damage (T1, myelin water, free water, intracellular volume) from iso/hypointense to paramagnetic rim lesions; paramagnetic rim lesions were closer to CSF and hyperintense lesions correlated with disease severity.
Conclusions:
- QSM and SWI enable in vivo classification of MS lesions into distinct phenotypes.
- Phenotypes correlate with axonal/myelin loss and spatial distribution.
- Hyperintense and paramagnetic rim lesions, indicative of severe microstructural damage, are periventricular and associated with a more severe disease course.
