A brain magnetization transfer MRI study with a clinical follow up of about four years in patients with clinically isolated syndromes suggestive of multiple sclerosis

Antonio Gallo, Marco Rovaris, Beatrice Benedetti, Maria Pia Sormani, Roberto Riva, Angelo Ghezzi, Vittorio Martinelli, Andrea Falini, Giancarlo Comi, Massimo Filippi

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13 Citations (Scopus)

Abstract

Whereas it is important to gain prognostic information in patients with clinically isolated syndromes (CIS) suggestive of multiple sclerosis (MS), there is still a lack of definitive data about the significance of normal-appearing white (NAWM) and gray (NAGM) matter damage in these patients. The aim of this study was to clarify the role of magnetization transfer magnetic resonance imaging (MT MRI) in assessing "occult" damage at the earliest clinical stage of MS. Dual echo, post-contrast T1-weighted, and MT MRI were obtained from 43 CIS patients with paraclinical evidence of spatial disease dissemination within 3 months from disease onset and from 22 controls. In patients, conventional MRI was obtained after 3 and 12 months from the baseline assessment, to detect disease dissemination in time (DIT). A neurological examination was also conducted to ascertain the occurrence of relapses for an average follow up period of 1389 (range = 420-1847) days. MTR maps were derived and NAWM and NAGM MT ratio (MTR) histograms were analyzed. During the follow up, 30 patients showed MRI evidence of DIT, and 21 experienced a relapse. T2 lesion volume (LV) was significantly higher in patients with DIT than in those without (p = 0.005). MTR histogram variables did not significantly differ between patients with MRI or clinical DIT. T2 LV was the only significant predictor of clinical DIT at follow-up (p = 0.001). This study shows that MT MRI-detectable damage to NAWM and NAGM may not be an important feature of all patients at presentation with a CIS highly suggestive of MS and that such a damage may develop with subsequent disease evolution.

Original languageEnglish
Pages (from-to)78-83
Number of pages6
JournalJournal of Neurology
Volume254
Issue number1
DOIs
Publication statusPublished - Jan 2007

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Multiple Sclerosis
Brain
Magnetic Resonance Imaging
Recurrence
Neurologic Examination

Keywords

  • Clinically isolated syndrome
  • Magnetization transfer MRI
  • MRI
  • Multiple sclerosis
  • Normal-appearing brain tissue

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

Cite this

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title = "A brain magnetization transfer MRI study with a clinical follow up of about four years in patients with clinically isolated syndromes suggestive of multiple sclerosis",
abstract = "Whereas it is important to gain prognostic information in patients with clinically isolated syndromes (CIS) suggestive of multiple sclerosis (MS), there is still a lack of definitive data about the significance of normal-appearing white (NAWM) and gray (NAGM) matter damage in these patients. The aim of this study was to clarify the role of magnetization transfer magnetic resonance imaging (MT MRI) in assessing {"}occult{"} damage at the earliest clinical stage of MS. Dual echo, post-contrast T1-weighted, and MT MRI were obtained from 43 CIS patients with paraclinical evidence of spatial disease dissemination within 3 months from disease onset and from 22 controls. In patients, conventional MRI was obtained after 3 and 12 months from the baseline assessment, to detect disease dissemination in time (DIT). A neurological examination was also conducted to ascertain the occurrence of relapses for an average follow up period of 1389 (range = 420-1847) days. MTR maps were derived and NAWM and NAGM MT ratio (MTR) histograms were analyzed. During the follow up, 30 patients showed MRI evidence of DIT, and 21 experienced a relapse. T2 lesion volume (LV) was significantly higher in patients with DIT than in those without (p = 0.005). MTR histogram variables did not significantly differ between patients with MRI or clinical DIT. T2 LV was the only significant predictor of clinical DIT at follow-up (p = 0.001). This study shows that MT MRI-detectable damage to NAWM and NAGM may not be an important feature of all patients at presentation with a CIS highly suggestive of MS and that such a damage may develop with subsequent disease evolution.",
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author = "Antonio Gallo and Marco Rovaris and Beatrice Benedetti and Sormani, {Maria Pia} and Roberto Riva and Angelo Ghezzi and Vittorio Martinelli and Andrea Falini and Giancarlo Comi and Massimo Filippi",
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T1 - A brain magnetization transfer MRI study with a clinical follow up of about four years in patients with clinically isolated syndromes suggestive of multiple sclerosis

AU - Gallo, Antonio

AU - Rovaris, Marco

AU - Benedetti, Beatrice

AU - Sormani, Maria Pia

AU - Riva, Roberto

AU - Ghezzi, Angelo

AU - Martinelli, Vittorio

AU - Falini, Andrea

AU - Comi, Giancarlo

AU - Filippi, Massimo

PY - 2007/1

Y1 - 2007/1

N2 - Whereas it is important to gain prognostic information in patients with clinically isolated syndromes (CIS) suggestive of multiple sclerosis (MS), there is still a lack of definitive data about the significance of normal-appearing white (NAWM) and gray (NAGM) matter damage in these patients. The aim of this study was to clarify the role of magnetization transfer magnetic resonance imaging (MT MRI) in assessing "occult" damage at the earliest clinical stage of MS. Dual echo, post-contrast T1-weighted, and MT MRI were obtained from 43 CIS patients with paraclinical evidence of spatial disease dissemination within 3 months from disease onset and from 22 controls. In patients, conventional MRI was obtained after 3 and 12 months from the baseline assessment, to detect disease dissemination in time (DIT). A neurological examination was also conducted to ascertain the occurrence of relapses for an average follow up period of 1389 (range = 420-1847) days. MTR maps were derived and NAWM and NAGM MT ratio (MTR) histograms were analyzed. During the follow up, 30 patients showed MRI evidence of DIT, and 21 experienced a relapse. T2 lesion volume (LV) was significantly higher in patients with DIT than in those without (p = 0.005). MTR histogram variables did not significantly differ between patients with MRI or clinical DIT. T2 LV was the only significant predictor of clinical DIT at follow-up (p = 0.001). This study shows that MT MRI-detectable damage to NAWM and NAGM may not be an important feature of all patients at presentation with a CIS highly suggestive of MS and that such a damage may develop with subsequent disease evolution.

AB - Whereas it is important to gain prognostic information in patients with clinically isolated syndromes (CIS) suggestive of multiple sclerosis (MS), there is still a lack of definitive data about the significance of normal-appearing white (NAWM) and gray (NAGM) matter damage in these patients. The aim of this study was to clarify the role of magnetization transfer magnetic resonance imaging (MT MRI) in assessing "occult" damage at the earliest clinical stage of MS. Dual echo, post-contrast T1-weighted, and MT MRI were obtained from 43 CIS patients with paraclinical evidence of spatial disease dissemination within 3 months from disease onset and from 22 controls. In patients, conventional MRI was obtained after 3 and 12 months from the baseline assessment, to detect disease dissemination in time (DIT). A neurological examination was also conducted to ascertain the occurrence of relapses for an average follow up period of 1389 (range = 420-1847) days. MTR maps were derived and NAWM and NAGM MT ratio (MTR) histograms were analyzed. During the follow up, 30 patients showed MRI evidence of DIT, and 21 experienced a relapse. T2 lesion volume (LV) was significantly higher in patients with DIT than in those without (p = 0.005). MTR histogram variables did not significantly differ between patients with MRI or clinical DIT. T2 LV was the only significant predictor of clinical DIT at follow-up (p = 0.001). This study shows that MT MRI-detectable damage to NAWM and NAGM may not be an important feature of all patients at presentation with a CIS highly suggestive of MS and that such a damage may develop with subsequent disease evolution.

KW - Clinically isolated syndrome

KW - Magnetization transfer MRI

KW - MRI

KW - Multiple sclerosis

KW - Normal-appearing brain tissue

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