Weekly multimodal MRI follow‐up of two multiple sclerosis active lesions presenting a transient decrease in ADC

Brain and Behavior

Salem Hannoun¹  Jean-Amédée Roch²  Francoise Durand-Dubief¹  Sandra Vukusic⁴  Dominique Sappey-Marinier¹  Charles R.G. Guttmann³ 

[1] CREATIS – CNRS UMR 5220 & INSERM U1044, Université Claude Bernard-Lyon1, Villeurbanne, France;Service de Radiologie, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre-Bénite, France;Center for Neurological Imaging, Brigham and Women's Hospital, Boston, Massachusetts;Service de Neurologie A & EDMUS Coordinating Center for Multiple Sclerosis, Hôpital Neurologique Pierre Wertheimer, Bron, France

关键词: Apparent diffusion coefficient;    diffusion tensor imaging;    lesions;    multiple sclerosis;    perfusion;    relative cerebral blood volume;   

DOI  :  10.1002/brb3.307

来源: Wiley

【 摘 要 】

Abstract

Background and purpose

Blood-brain barrier disruption during the earliest phases of lesion formation in multiple sclerosis (MS) patients is commonly ascribed to perivenular inflammatory activity and is usually accompanied by increased diffusivity. Reduced diffusivity has also been shown in active lesions, albeit less frequently. This study aimed to characterize the development and natural history of contrast-enhanced lesions by weekly following five relapsing remitting (RR) MS patients.

Materials and methods

Diffusion tensor imaging (DTI), perfusion imaging, FLAIR and contrast-enhanced 3D T1-weighted MR, were weekly performed on five untreated patients recently diagnosed with RR MS.

Results

All five patients showed significant increases of the apparent diffusion coefficient (ADC) in the lesions compared to the first time point. One of the five patients presented 98 active lesions on ADC maps among which 36 had a volume larger than 10 mm³. In two of these lesions, a 1 week transient decrease in ADC was detected at the time of the first gadolinium enhancement. Also, the perfusion analysis showed a concomitant increase in the relative cerebral blood volume.

Conclusions

The infrequency detection of such ADC decrease in a new lesion is probably due to its very short duration. This observation may be consistent with a hyper-acute inflammatory stage concomitant with an increased reactional perfusion.

【 授权许可】

CC BY   
© 2015 The Authors. Brain and Behavior published by Wiley Periodicals, Inc.

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