Cerebral vein changes in relapsing-remitting multiple sclerosis demonstrated by three-dimensional enhanced T2-weighted angiography at 3.0 T.

OBJECTIVE: To investigate characteristics of the internal cerebral veins (ICVs) and their main tributaries and the deep medullary veins (DMVs) in patients with relapsing-remitting MS (RRMS) with enhanced T (2)-weighted angiography imaging (ESWAN). METHODS: Fifty-three RRMS patients and 53 normal controls underwent conventional MRI and ESWAN. ESWAN venograms were created by performing minimum intensity projections of the phase images, and the resulting venograms were used to observe characteristic vascular changes, including scores of the ICVs and their main tributaries and manifestations of the DMVs. Two experienced radiologists analysed all data. RESULTS: Patients showed decreased mean scores of the ICVs and their main tributaries compared with controls. The mean score in acute patients was higher than in stable patients. Furthermore, the DMVs diminished and shortened in 48 patients with longer disease duration, whereas the DMVs increased and elongated in 5 patients with shorter disease duration. The penetrating veins were well defined in 30 active lesions, whereas the veins were ill defined in 69 non-active lesions. Interestingly, well-defined penetrating veins were shown in 15 non-active lesions in the stable patients. CONCLUSIONS: Enhanced T (2)-weighted MR angiography can detect cerebral vein characteristics in relapsing-remitting MS patients, which may provide important information on the pathogenesis of MS.

Iron deposition in the precentral grey matter in patients with multiple sclerosis: a quantitative study using susceptibility-weighted imaging.

PURPOSE: Several studies suggest that iron deposition may play a role in multiple sclerosis (MS) pathology. Three-dimensional (3D) enhanced T2*-weighted angiography (ESWAN) at 3T was used to quantify iron deposition in the precentral grey matter in MS and its relationship with disease duration, atrophy and Expanded Disability Status Scale (EDSS) scores. METHODS: We recruited 33 patients with diagnosis of clinically definite MS and 31 age- and sex-matched healthy controls who underwent conventional brain MRI, 3D-ESWAN and 3D T1sequences. We obtained the mean phase values (MPVs) of the precentral grey matter on ESWAN-filtered phase images and volume of the precentral gyrus on 3D T1 images. We investigated the correlation between precentral grey matter MPVs, precentral gyrus volume, disease duration and EDSS scores of MS patients and healthy controls. RESULTS: The precentral grey matter MPVs in MS patients and controls were 1870.83 ± 56.61 and 1899.22 ± 51.73 respectively and had significant difference in the MS group vs. the control group (t=-2.09, P=0.04). There was significant negative correlation between precentral grey matter MPVs and disease duration (r=-0.365, P=0.03). No correlation was found between MPVs and EDSS scores. Mean precentral gyrus volume in MS patients was 4368.55 ± 867.78 whereas in controls was 5701.00 ± 1184.03 with significant difference between volume of the precentral gyrus in MS patients compared to healthy controls (t=-5.167, P<0.001). There was a positive correlation between MPVs and precentral gyrus volume (r=0.291, P=0.020). CONCLUSIONS: Our study demonstrated that quantitative assessment of abnormal iron deposition in the precentral grey matter in MS patients can be measured using 3D-ESWAN.

Gray matter involvement in patients with multiple sclerosis as shown by magnetic resonance imaging.

OBJECTIVE: To summarize the main findings seen on conventional and advanced magnetic resonance imaging (MRI) used to assess gray matter (GM) involvement in patients with multiple sclerosis (MS). DATA SOURCES: The data used in this review were obtained mainly from studies reported in the PubMed database using the terms of multiple sclerosis, gray matter, magnetic resonance imaging. STUDY SELECTION: Relevant literatures on studies of GM involvement in MS patients were identified, retrieved and reviewed. RESULTS: MS is the most common chronic, disabling central nervous system disease in young adults. Although traditional thinking has considered MS to be a chronic inflammatory demyelinating condition affecting solely the white matter (WM) of the central nervous system, over the last few years it has been shown that GM pathology is also common and extensive. GM demyelinating lesions can not only be found in the cerebral cortex but also in the deep gray nuclei. Apart from focal demyelinated lesions, diffuse neuronal loss and atrophy is also present in the GM of MS patients. CONCLUSIONS: The widespread use of conventional and quantitative MRI based techniques in MS has led to an improved understanding of the mechanisms underlying the inflammatory and neurodegenerative processes of the disease. However, more researches are needed to unravel GM pathology in MS patients, which at present remains enigmatic.

Iron deposition of the deep grey matter in patients with multiple sclerosis and neuromyelitis optica: a control quantitative study by 3D-enhanced susceptibility-weighted angiography (ESWAN).

PURPOSE: Previous studies have detected abnormal iron deposition in the deep grey matter (DGM) of multiple sclerosis (MS). The regional specificity of the DGM iron deposition in neuromyelitis optica (NMO) is still unclear. We compared the differences in the DGM iron concentration between MS and NMO patients. METHODS: We enrolled 42 relapsing-remitting MS (RRMS) patients, 42 NMO patients and 42 healthy controls undergoing brain conventional MRI and three-dimensional (3D)-enhanced T(2)*-weighted angiography (ESWAN) sequences. We obtained the mean phase values (MPVs) for ESWAN-filtered phase images. An analysis of covariance (ANCOVA) was used to compare MPVs among three groups. The correlations of MPVs changes with disease duration and expanded disability status scale (EDSS) were analyzed. RESULTS: The RRMS patients had higher DGM iron concentration than did the NMO and control groups, but only the bilateral substantia nigra (SN) showed a significant statistical difference among three groups (p<0.05). In the RRMS group, the iron concentration in the bilateral head of the caudate nucleus (HCN) (left: p<0.0001; right: p=0.0134) and the dentate nucleus (DN) (p<0.05 for both) were correlated with disease duration. In the NMO group, no correlation was found between the DGM iron concentration and disease duration (p>0.05). Furthermore, no correlations were found between the DGM iron concentration and EDSS (p>0.05). CONCLUSIONS: We confirm the iron concentration in the DGM iron content of MS patients is more than NMO patients and healthy controls in the same age range. Furthermore, the disease duration was found to be a significant contributor to patients with MS.