Improved Lesion Detection by Using Axial T2-Weighted MRI with Full Spinal Cord Coverage in Multiple Sclerosis

Galler, S.; Stellmann, Jan‐Patrick; Young, Kim Lea; Kutzner, Daniel; Heesen, Christoph; Fiehler, Jens; Siemonsen, Susanne

doi:10.3174/ajnr.a4638

Cited by 21 publications

(14 citation statements)

References 29 publications

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“…The PES scores were higher in NMOSD than in MS patients in this study. Several studies reported 75%-90% of patients with MS showed spinal cord lesions [22][23][24][25]. The percentages are similar to our study.…”

Section: Discussionsupporting

confidence: 91%

Difference in fatigue and pain between neuromyelitis optica spectrum disorder and multiple sclerosis

et al. 2020

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ObjectiveTo investigate the difference of fatigue and pain in patients with neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS). MethodsData from the Modified Fatigue Impact Scale (MFIS) and Pain Effects Scale (PES) were compared between 51 NMOSD and 85 MS patients. Each score was compared in each disease group with or without clinical abnormalities. Since almost no MS patients are without brain magnetic resonance imaging abnormalities, volumetry analysis by the Lesion Segmentation Tool and statistical parametric mapping 12 were added to obtain total lesion volume and intracranial volume in MS patients, and the correlations between total lesion volume/intracranial volume and each score were investigated. ResultsCompared to the MS group, the NMOSD group showed a higher PES score (median, 15.0 vs. 7.0, P = 0.045), no difference in MFIS, and an increased percentage of patients with extended spinal cord lesions (58.8% vs. 8.2%, P < 0.001). Moreover, NMOSD and MS patients with extended spinal cord lesions tended to demonstrate higher PES scores than those without. A positive correlation between MFIS and PES were found in patients with NMOSD and MS. On the other hand, MS patients showed a higher percentage of brain abnormalities (80.4% vs. 97.6%, P = 0.001) and a positive correlation between total lesion volume/intracranial volume and MFIS (Spearman's ρ = 0.50, P = 0.033). ConclusionsThe origin of fatigue may be associated with spinal cord lesions causing pain in NMOSD patients, but with brain lesions in MS patients.

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Section: Discussionsupporting

confidence: 91%

Difference in fatigue and pain between neuromyelitis optica spectrum disorder and multiple sclerosis

et al. 2020

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“…It is estimated that focal spinal cord lesions are present in approximately 50% of PPMS patients [89][90][91]. It is very important to highlight that although in current and very recently published guidelines for diagnosis and monitoring MS patients [92] the sagittal plane is recommended for lesions detection, using additional axial plane more lesions are detected [93,94]. Galler et al [93].…”

Section: Focal T2-weighted Lesionsmentioning

confidence: 99%

“…It is very important to highlight that although in current and very recently published guidelines for diagnosis and monitoring MS patients [92] the sagittal plane is recommended for lesions detection, using additional axial plane more lesions are detected [93,94]. Galler et al [93]. applied axial T2-weighted sequences with full spinal cord.…”

Section: Focal T2-weighted Lesionsmentioning

confidence: 99%

Magnetic Resonance Imaging in Primary Progressive Multiple Sclerosis Patients

Siger

2022

Clin Neuroradiol

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The recently developed effective treatment of primary progressive multiple sclerosis (PPMS) requires the accurate diagnosis of patients with this type of disease. Currently, the diagnosis of PPMS is based on the 2017 McDonald criteria, although the contribution of magnetic resonance imaging (MRI) to this process is fundamental. PPMS, one of the clinical types of MS, represents 10%–15% of all MS patients. Compared to relapsing–remitting MS (RRMS), PPMS differs in terms of pathology, clinical presentation and MRI features. Regarding conventional MRI, focal lesions on T2-weighted images and acute inflammatory lesions with contrast enhancement are less common in PPMS than in RRMS. On the other hand, MRI features of chronic inflammation, such as slowly evolving/expanding lesions (SELs) and leptomeningeal enhancement (LME), and brain and spinal cord atrophy are more common MRI characteristics in PPMS than RRMS. Nonconventional MRI also shows differences in subtle white and grey matter damage between PPMS and other clinical types of disease. In this review, we present separate diagnostic criteria, conventional and nonconventional MRI specificity for PPMS, which may support and simplify the diagnosis of this type of MS in daily clinical practice.

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“…For axial imaging, possible sequences are 2D or 3D T2-weighted fast spin-echo sequences. A full cervical cord axial coverage detects more lesions (9–22%) than sagittal scans alone, 11,22 and can also exclude lesions in cases of equivocal abnormalities on sagittal scans. 11,22,23…”

Section: Spinal Cord Lesionsmentioning

confidence: 99%

Advances in spinal cord imaging in multiple sclerosis

Moccia

Ruggieri

Ianniello

et al. 2019

Ther Adv Neurol Disord

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The spinal cord is frequently affected in multiple sclerosis (MS), causing motor, sensory and autonomic dysfunction. A number of pathological abnormalities, including demyelination and neuroaxonal loss, occur in the MS spinal cord and are studied in vivo with magnetic resonance imaging (MRI). The aim of this review is to summarise and discuss recent advances in spinal cord MRI. Advances in conventional spinal cord MRI include improved identification of MS lesions, recommended spinal cord MRI protocols, enhanced recognition of MRI lesion characteristics that allow MS to be distinguished from other myelopathies, evidence for the role of spinal cord lesions in predicting prognosis and monitoring disease course, and novel post-processing methods to obtain lesion probability maps. The rate of spinal cord atrophy is greater than that of brain atrophy (−1.78% versus −0.5% per year), and reflects neuroaxonal loss in an eloquent site of the central nervous system, suggesting that it can become an important outcome measure in clinical trials, especially in progressive MS. Recent developments allow the calculation of spinal cord atrophy from brain volumetric scans and evaluation of its progression over time with registration-based techniques. Fully automated analysis methods, including segmentation of grey matter and intramedullary lesions, will facilitate the use of spinal cord atrophy in trial designs and observational studies. Advances in quantitative imaging techniques to evaluate neuroaxonal integrity, myelin content, metabolic changes, and functional connectivity, have provided new insights into the mechanisms of damage in MS. Future directions of research and the possible impact of 7T scanners on spinal cord imaging will be discussed.

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Improved Lesion Detection by Using Axial T2-Weighted MRI with Full Spinal Cord Coverage in Multiple Sclerosis

Cited by 21 publications

References 29 publications

Difference in fatigue and pain between neuromyelitis optica spectrum disorder and multiple sclerosis

Difference in fatigue and pain between neuromyelitis optica spectrum disorder and multiple sclerosis

Magnetic Resonance Imaging in Primary Progressive Multiple Sclerosis Patients

Advances in spinal cord imaging in multiple sclerosis

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