Learning objectives
How iron deposits are visualizedon T2 susceptibility weighted images (SWI) in Multiple Sclerosis (MS) white matter (WM) lesions.
Correlate iron deposits and dissemination in time (DIT) in MS.
Background
Multiple sclerosis (MS) is an inflammatory disease of the central nervous system (CNS) characterized by infiltration of immune cells and subsequent loss of myelin, oligodendrocytes, and axons. Conventional magnetic resonance imaging (MRI) is used routinely for diagnosis and monitoring disease activity.
There are many challenges in determining the time (DIT) and space dissemination (DIS) in MS. They were addressed at the latest McDonald criteria, which characterized DIT as at least one new T2 and/or gadolinium-enhancing lesion on follow-up Magnetic Resonance (MRI)compared to a baseline MRI...
Findings and procedure details
In iron-sensitive GRE phase imaging in MS patients iron is present in non-phagocytosing, M1-polarized microglia/macrophages at the rim of chronic active white matter demyelinating lesions. Phase imaging may therefore visualize specific, chronic proinflammatory activity in established MS lesions and thus provide important clinical information on disease status and treatment efficacy in MS patients.
In light of determining which of those advanced imaging sequences could support the evidence of DIS, alongside with studies to standardize the use of the central vein sign as a marker for...
Conclusion
MS lesion magnetic susceptibility increased rapidly as it changed from enhanced to nonenhanced, it attained a high susceptibility value relative to NAWM during its initial few years, and it gradually dissipated back to a susceptibility value similar to NAWM as it further aged, which may provide a new insight into the pathophysiologic effect of MS lesions.
As previously stated, the search for new methods in establishing DIS and DIT in neuroimaging is required in order to improve accuracy in the diagnostic methods in MS. These...
Personal information and conflict of interest
J. A. Duarte; PORTO ALEGRE, RS/BR - nothing to disclose V. S. Viuniski; Porto Alegre/BR - nothing to disclose D. Nakata; Sao Paulo/BR - nothing to disclose
References
Hauser SL, Oksenberg JR (2006) The neurobiology of multiple sclerosis: genes, inflammation, and neurodegeneration. Neuron 52:61–76. https://doi: 10.1016/j.neuron.2006.09.011
Williams, R., Buchheit, C. L., Berman, N. E. J., & Levine, S. M. (2012, January). Pathogenic implications of iron accumulation in multiple sclerosis. Journal of Neurochemistry. https://doi.org/10.1111/j.1471-4159.2011.07536.x
Gillen, K. M., Mubarak, M., Nguyen, T. D., & Pitt, D. (2018). Significance and in vivo detection of iron-laden microglia in white matter multiple sclerosis lesions. Frontiers in Immunology, 9(FEB). https://doi.org/10.3389/fimmu.2018.00255
Hagemeier, J., Heininen-Brown, M., Poloni, G. U., Bergsland, N.,...