Increased cortical grey matter lesion detection in multiple sclerosis with 7 T MRI: a post-mortem verification study.

Autor:	Kilsdonk ID; Department of Radiology and Nuclear Medicine, VU University Medical Centre, Amsterdam, The Netherlands i.kilsdonk@vumc.nl., Jonkman LE; Department of Anatomy and Neurosciences, VU University Medical Centre, Amsterdam, The Netherlands., Klaver R; Department of Anatomy and Neurosciences, VU University Medical Centre, Amsterdam, The Netherlands., van Veluw SJ; Department of Neurology, University Medical Centre Utrecht, Utrecht, The Netherlands., Zwanenburg JJ; Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands., Kuijer JP; Department of Physics and Medical Technology, VU University Medical Centre, Amsterdam, The Netherlands., Pouwels PJ; Department of Physics and Medical Technology, VU University Medical Centre, Amsterdam, The Netherlands., Twisk JW; Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands., Wattjes MP; Department of Radiology and Nuclear Medicine, VU University Medical Centre, Amsterdam, The Netherlands., Luijten PR; Department of Neurology, University Medical Centre Utrecht, Utrecht, The Netherlands., Barkhof F; Department of Radiology and Nuclear Medicine, VU University Medical Centre, Amsterdam, The Netherlands., Geurts JJ; Department of Anatomy and Neurosciences, VU University Medical Centre, Amsterdam, The Netherlands.
Jazyk:	angličtina
Zdroj:	Brain : a journal of neurology [Brain] 2016 May; Vol. 139 (Pt 5), pp. 1472-81. Date of Electronic Publication: 2016 Mar 08.
DOI:	10.1093/brain/aww037
Abstrakt:	The relevance of cortical grey matter pathology in multiple sclerosis has become increasingly recognized over the past decade. Unfortunately, a large part of cortical lesions remain undetected on magnetic resonance imaging using standard field strength. In vivo studies have shown improved detection by using higher magnetic field strengths up to 7 T. So far, a systematic histopathological verification of ultra-high field magnetic resonance imaging pulse sequences has been lacking. The aim of this study was to determine the sensitivity of 7 T versus 3 T magnetic resonance imaging pulse sequences for the detection of cortical multiple sclerosis lesions by directly comparing them to histopathology. We obtained hemispheric coronally cut brain sections of 19 patients with multiple sclerosis and four control subjects after rapid autopsy and formalin fixation, and scanned them using 3 T and 7 T magnetic resonance imaging systems. Pulse sequences included T1-weighted, T2-weighted, fluid attenuated inversion recovery, double inversion recovery and T2*. Cortical lesions (type I-IV) were scored on all sequences by an experienced rater blinded to histopathology and clinical data. Staining was performed with antibodies against proteolipid protein and scored by a second reader blinded to magnetic resonance imaging and clinical data. Subsequently, magnetic resonance imaging images were matched to histopathology and sensitivity of pulse sequences was calculated. Additionally, a second unblinded (retrospective) scoring of magnetic resonance images was performed. Regardless of pulse sequence, 7 T magnetic resonance imaging detected more cortical lesions than 3 T. Fluid attenuated inversion recovery (7 T) detected 225% more cortical lesions than 3 T fluid attenuated inversion recovery (Z = 2.22, P < 0.05) and 7 T T2* detected 200% more cortical lesions than 3 T T2* (Z = 2.05, P < 0.05). Sensitivity of 7 T magnetic resonance imaging was influenced by cortical lesion type: 100% for type I (T2), 11% for type II (FLAIR/T2), 32% for type III (T2*), and 68% for type IV (T2). We conclude that ultra-high field 7 T magnetic resonance imaging more than doubles detection of cortical multiple sclerosis lesions, compared to 3 T magnetic resonance imaging. Unfortunately, (subpial) cortical pathology remains more extensive than 7 T magnetic resonance imaging can reveal. (© The Author (2016). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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