7T MRI cerebral leptomeningeal enhancement is common in relapsing-remitting multiple sclerosis and is associated with cortical and thalamic lesions

Meningeal inflammation may contribute to gray matter (GM) involvement in multiple sclerosis (MS) and is proposed to manifest as magnetic resonance imaging (MRI) leptomeningeal enhancement (LME). To investigate how LME relates to GM lesions in relapsing-remitting multiple sclerosis (RRMS) at 7T. A to...

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Published in:Multiple sclerosis Vol. 26; no. 2; p. 177
Main Authors: Zurawski, Jonathan, Tauhid, Shahamat, Chu, Renxin, Khalid, Fariha, Healy, Brian C, Weiner, Howard L, Bakshi, Rohit
Format: Journal Article
Language:English
Published: England 01.02.2020
Subjects:
Adult
Brain - diagnostic imaging
Brain - pathology
Female
Humans
Image Interpretation, Computer-Assisted
Magnetic Resonance Imaging - methods
Male
Meninges - diagnostic imaging
Meninges - pathology
Middle Aged
Multiple Sclerosis, Relapsing-Remitting - diagnostic imaging
Multiple Sclerosis, Relapsing-Remitting - pathology
Neuroimaging - methods
7T MRI
Leptomeningeal enhancement
cortical lesions
thalamic lesions
multiple sclerosis
ISSN:1477-0970, 1477-0970
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Summary:Meningeal inflammation may contribute to gray matter (GM) involvement in multiple sclerosis (MS) and is proposed to manifest as magnetic resonance imaging (MRI) leptomeningeal enhancement (LME). To investigate how LME relates to GM lesions in relapsing-remitting multiple sclerosis (RRMS) at 7T. A total of 30 RRMS subjects (age (mean ± standard deviation (SD)): 44.0 ± 11.3 years, 93% on disease-modifying treatment) and 15 controls underwent gadolinium-enhanced three-dimensional (3D) MP2RAGE (magnetization-prepared 2 rapid gradient-echo) and fluid-attenuated inversion recovery (FLAIR) MRI. LME, cortical lesions (CLs), thalamic lesions (TLs), and white matter (WM) lesions were expert-quantified. Wilcoxon rank-sum, two-sample -tests, Spearman correlations, and regression models were employed. Two-thirds (20/30) of MS subjects and 1/15 controls (6.7%) had LME. LME+ MS subjects had 2.7 ± 1.5 foci, longer disease duration (14.9 ± 10.4 vs. 8.1 ± 5.7 years,  = 0.028), increased CL number (21.5 ± 12.6 vs. 5.5 ± 5.0,  < 0.001) and volume (0.80 ± 1.13 vs. 0.13 ± 0.13 mL,  = 0.002), and increased TL number (3.95 ± 2.11 vs. 0.70 ± 1.34,  < 0.001) and volume (0.106 ± 0.09 vs. 0.007 ± 0.01 mL,  < 0.001) versus LME- subjects. LME focus number correlated more highly with CL (  = 0.50,  = 0.01) and TL (  = 0.81,  < 0.001) than WM lesion (  = 0.34,  > 0.05) volume. Similar LME-CL number associations were observed in unadjusted and WM lesion-adjusted comparisons (both  < 0.001). Cerebral LME is common in RRMS at 7T and is independently associated with GM injury. We hypothesize that cerebrospinal fluid (CSF)-related inflammation links cortical and thalamic injury.
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ISSN:1477-0970
1477-0970
DOI:10.1177/1352458519885106