Magnetic Resonance Phase Alterations in Multiple Sclerosis Patients with Short and Long Disease Duration.

Ivan Bozin,Tim Sinnecker,Yulin Ge,Friedemann Paul,Ilya Kister,Petr Dusek,Lutz Harms,Jens Wuerfel,Joseph Kuchling,Sanjeev Chawla,Klemens Ruprecht,Thoralf Niendorf

doi:10.1371/journal.pone.0128386

Abstract

ObjectiveThe analysis of the MR phase provides additional information on the tissue microstructure. In multiple sclerosis (MS) lesions phase alterations may reflect different stages of inflammatory activity. Here we investigated lesion morphology in MS patients with short and long disease duration on T2* weighted, phase, magnitude and susceptibility weighted imaging (SWI) at 7 Tesla (T).Methods17 MS or clinically isolated syndrome patients with short (<60 months) and 11 with long (>60 months) disease duration underwent 7T MRI. Lesions were subsequently analyzed side-by-side with regard to morphology and visibility on T2* weighted, SWI, magnitude and SWI-filtered phase images.Results126 of 192 T2* weighted lesions (65.6%) were characterized by a phase alteration pattern, and hence could be differentiated on phase images. In detail, a significantly reduced proportion of lesions showing phase alterations was detectable in patients with longer disease duration (mean±SD 51±37%, range 0–100%) compared to patients with short disease duration (mean±SD 90±19.5%, range 50–100%, p = 0.003).ConclusionThis cross-sectional study identified different patterns of phase changes in lesions of MS patients with short and long standing disease. Longitudinal studies are warranted to prove that MR phase imaging is useful in determining the activity and the developmental stage of individual MS plaques.

Highlights

Multiple Sclerosis (MS) is an inflammatory, demyelinating and neurodegenerative central nervous system disease [1]
A significantly reduced proportion of lesions showing phase alterations was detectable in patients with longer disease duration compared to patients with short disease duration
Longitudinal studies are warranted to prove that magnetic resonance (MR) phase imaging is useful in determining the activity and the developmental stage of individual MS plaques

Summary

Introduction

Multiple Sclerosis (MS) is an inflammatory, demyelinating and neurodegenerative central nervous system disease [1]. Magnetic resonance imaging (MRI) improved early MS diagnosis by demonstrating spatiotemporal lesion dissemination. Ultrahigh field MRI at 7 Tesla (T) visualizes focal MS lesions in great detail [3,4,5]. Gaining from increased signal to noise ratio and enhanced susceptibility effects, MS lesions on 7T T2Ã weighted (T2Ãw) images frequently display a small central vein. A proportion of lesions exhibits a hypointense rim. Both characteristics can be used to distinguish MS from other white-matter pathologies such as neuromyelitis optica [5], Susac syndrome [6], and white matter lesions of presumably vascular origin [7,8], which improves the diagnosis of MS [9]

Methods

Results

Conclusion