Abstract Details

Title Slowly Expanding Lesions in Multiple Sclerosis: An In Vivo Demonstration

Topic MS and Related Diseases

Presentation(s) S21 - (-)

Poster/Presentation
Number 006

Objective

Background Multi-echo T2*-weighted (T2*-w) gradient echo (ME-GRE) magnetic resonance imaging (MRI) at 7 Tesla (7T) permits identifying iron in brain tissue of patients with multiple sclerosis (MS). In some white matter lesions (WM-Ls), iron is detectable as a hyperintense ring surrounding a hypointense core of demyelination on R2* ME-GRE images. Such iron is contained in activated microglia cells of SELs.

Design/Methods Sixteen MS patients underwent 3T and 7T MRIs two weeks apart. Conventional sequences at 3T identified WM-Ls and ME-GRE at 7T identified SELs. SELs were defined as hypointense lesions surrounded by a partial or complete ring of R2* signal increase.

Results Thirty-seven SELs were identified in 11 (68.7%) patients with any MS type and variable disability or disease duration. Of these 37 SELs, three (8.1%) SELs did not have a correspondent signal alteration in T2-w FSE and FLAIR images. Twelve (25.5%) SELs appeared in the context of larger confluent lesions in T2-w FLAIR images. Eighteen (48.6%) SELs were associated to the presence of a cBH and 10 (27.0%) were associated to the presence of a lesion by CSF-TSI. A central vein was seen to cross 12 (32.4%) SELs.

Conclusions Slowly expanding activity surrounding focal WM-Ls or as part of extensive WM damage is identifiable in vivo at any stage of MS.

Authors/Disclosures
Francesca Bagnato, MD (Vanderbilt University Medical Center) PRESENTER	Dr. Bagnato has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi-Genzyne. Dr. Bagnato has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen. Dr. Bagnato has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Jenseen. Dr. Bagnato has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merk-Serono.
	No disclosure on file
Vasiliki N. Ikonomidou (NINDS/NIH)	No disclosure on file
	No disclosure on file
A. Gordon Smith, MD, FAAN (VCU Health System Department of Neurology)	Dr. Smith has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Smith has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Argenx. Dr. Smith has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merz. Dr. Smith has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sangamo. Dr. Smith has received personal compensation in the range of $500-$4,999 for serving as a Consultant for US Department of Justice. Dr. Smith has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. Dr. Smith has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Eidos. Dr. Smith has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Lexicon. Dr. Smith has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. The institution of Dr. Smith has received research support from NIH (NINDS, NIDDK). Dr. Smith has received publishing royalties from a publication relating to health care. Dr. Smith has received personal compensation in the range of $0-$499 for serving as a Study Section with NIH.
Fredric K. Cantor, MD, FAAN (National Institute of Neurological Disease & Stroke)	No disclosure on file
Joan M. Ohayon (National Institutes of Health)	Joan M. Ohayon has nothing to disclose.
Nancy D. Richert, MD, PhD (Research Imaging LLC)	No disclosure on file
	No disclosure on file
Jeff Duyn, PhD (NIH)	No disclosure on file
	No disclosure on file

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