| Multiple Sclerosis - Clinical Applications |
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Tuesday 21 April 2009 |
| Room 310 |
16:00-18:00 |
Moderators: |
Nicola de Stefano and Massimo Filippi |
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16:00 |
337. |
High Resolution Magnetization
Transfer Imaging at 7T |
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Olivier E. Mougin1,
Ali al-Radaideh1, Ron Coxon1,
Emma C. Tallantyre2, Matthew J. Brookes1,
Nikos Evangelou3, Penny A. Gowland1
1Sir Peter Mansfield Magnetic Resonance
Centre, School of Physics and Astronomy, University
of Nottingham, Nottingham, Nottinghamshire, UK;
2Departement of Clinical Neurology, Medical
School, University of Nottingham, Nottingham,
Nottinghamshire, UK; 3School of Medical &
Surgical Sciences, University of Nottingham,
Nottingham, Nottinghamshire, UK |
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High resolution
(1x1x1mm3) MTR scans have been acquired at 7T using
a novel imaging sequence. The MTR contrast has been
compared between 7 and 3T, showing a greater grey
matter (GM) / white matter (WM) contrast to noise
ratio at 7T, providing a good delineation of WM
lesions at high resolution with the MTR contrast.
The sequence is being used to study white matter
changes in MS patients. |
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16:12 |
338. |
Regions of Reduced Cortical
Magnetization Transfer Ratio Detected in MS Patients
Using Surface-Based Techniques |
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Mishkin Derakhshan1,
Zografos Caramanos1, Sridar Narayanan1,
Donald Louis Collins1, Douglas Lorne
Arnold1
1Montreal Neurological Institue, McGill
University, Montreal, QC, Canada |
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The multiple sclerosis
imaging community still struggles with the in
vivo detection of cortical grey matter lesions.
In this abstract we quantified the extent of subpial
decreases of magnetization transfer ratio of the
cortical grey matter, which may indicate regions of
cortical demyelination, in groups of MS patients and
healthy controls. To increase our sensitivity, we
exploited the knowledge gained from pathological
studies of the unique geometry of these lesions, and
carried out our analyses on two-dimensional
parametric surface models of the cortex, instead of
the three-dimensional voxel-wise analyses
traditionally used. |
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16:24 |
339. |
Optimisation of 7T
Double-Inversion Recovery (DIR) Imaging to Improve
Detection of MS Lesions In Vivo |
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Jennifer Elizabeth
Dixon1, Paul S. Morgan2,3,
Matthew J. Brookes1, Ali M. Al-Radaideh1,
Emma C. Tallantyre4, Nikos Evangelou4,
Peter G. Morris1
1Sir Peter Mansfield Magnetic Resonance
Centre, University of Nottingham, Nottingham,
Nottinghamshire, UK; 2Radiology &
Radiological Science, Medical University of South
Carolina, Charleston, SC, USA; 3Academic
Radiology, University of Nottingham, Nottingham,
Nottinghamshire, UK; 4Department of
Clinical Neurology, University of Nottingham,
Nottingham, Nottinghamshire, UK |
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DIR sequences have
proved useful in the detection of cortical MS
lesions. However, the inherently low SNR of this
sequence suggests the importance of developing it at
higher field. This requires the determination of
inversion times to provide the desired contrast
between grey matter, white matter and CSF, and must
address the effects of variation in flip angle due
to B1 inhomogeneity at 7T, as well as
reduce the TR to obtain clinically acceptable scan
times. We use this theory to produce high-resolution
images acquired at 7T, which show clearly areas of
signal hyperintensity associated with MS lesions. |
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16:36 |
340. |
Detection of Cortical Lesions
in Multiple Sclerosis Using FLAIR, DIR and Ultra
High Field MPRAGE |
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Emma Clare Tallantyre1,
Jennifer E. Dixon2, Matthew J. Brookes2,
Ali Al-Radaideh2, Paul S. Morgan3,4,
Nikos Evangelou1, Peter G. Morris2
1Clinical Neurology, Nottingham University,
Nottingham, UK; 2Sir Peter Mansfield MR
Centre, Nottingham University, Nottingham, UK;
3Radiology & Radiological Sciences, Medical
University of South Carolina, Charleston, USA;
4Academic Radiology, Nottingham University,
Nottingham, UK |
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Objective: To
investigate whether cortical MS lesions detected
using 3T DIR are also seen using ultra high field
(7T) MRI. Methods: MR imaging at 3T and 7T of 11 MS
patients and 8 controls. Results: DIR was
susceptible to artefact in controls. A proportion of
cortical lesions identified on 3T DIR appear to be
genuine. However, enhanced spatial resolution of 7T
MPRAGE better determines the anatomical location of
lesions and some cortical hyperintensities on 3T DIR
seem to arise from extracortical blood vessels.
Conclusions: Ultra high field MRI increases
sensitivity and specificity in the detection of
cortical lesions. |
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16:48 |
341. |
Evaluation of Cortical Lesions
Conspicuity in Multiple Sclerosis: 7T Vs 3T MRI |
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Caterina Mainero1,
Thomas Benner1, Amy Radding1,
Rikke Jensen2, Andre van der Kouwe1,
R P. Kinkel2, Bruce R. Rosen1
1A. A. Martinos Center for Biomedical Imaging,
Massachusetts General Hospital, Charlestown, MA,
USA; 2Neurology, Beth Israel Deaconess
Medical Center, Boston, MA, USA |
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In this study we
assessed the use of 7T MRI to (1) visualize cortical
lesions, including all histopathological types, in
patient with multiple sclerosis (MS); (2)
characterize the contrast properties of cortical
lesions including T2*, T2, T1, and phase images to
assess which MR contrasts are more sensitive to
cortical pathology; (3) compare the ability of the
7T images that showed higher contrast for cortical
plaques with that from 3T in disclosing cortical MS
pathology. 7T MRI, and particularly FLASH-T2* scans,
showed greater potential than 3T MRI not only in
detecting cortical lesions but also in
characterizing them as described histopathologically. |
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17:00 |
342. |
High Resolution In-Vivo
and Post-Mortem R2* and
Phase Images of Multiple Sclerosis Lesions at 7 T |
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Bing Yao1,
Francesca Bagnato1, Hellmut Merkle1,
Peter van Gelderen1, Fredric K. Cantor1,
Joan Ohayon1, Henry McFarland1,
Jeff H. Duyn1
1NINDS, National Institutes of Health,
Bethesda, MD , USA |
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R2* and phase images
have been exploited to investigate brain tissue
microstructure. In this study, MS patients and brain
specimens of an MS deceased patient were imaged
using a 7 T MR scanner and the R2* and phase images
were investigated. Heterogeneity appearances of the
MS lesions are found in the high resolution R2* and
phase images, for both in-vivo and extra-vivo
tissues. We here aim at providing new insights on
the major sources that contribute to the MRI
contrast in MS lesions. |
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17:12 |
343. |
Demyelination and
Remyelination in New Multiple Sclerosis Lesions:
Insights from Serial Myelin Water Imaging |
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Cornelia Laule1,
Irene M. Vavasour1, Shannon H. Kolind2,
Burkhard Maedler3, Anthony L. Traboulsee4,
Penny Smyth4, Alex Rauscher1,
John Hooge4, Virginia Devonshire4,
Joel Oger4, Wayne Moore5,
David KB Li1,4, Alex L. MacKay1,2
1Radiology, UBC, Vancouver, BC, Canada; 2Physics
& Astronomy, UBC, Vancouver, BC, Canada; 3Philips
Healthcare, Vancouver, BC, Canada; 4Neurology,
UBC, Vancouver, BC, Canada; 5Pathology &
Laboratory Medicine, UBC, Vancouver, BC, Canada |
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Histological studies
show cycles of demyelination and remyelination occur
in multiple sclerosis (MS) lesions. MR measures of
myelin water fraction (MWF), water content (WC) and
geometric mean T2 (GMT2)
measured by multi-echo T2 relaxation
provide insight into the myelination state of MS
lesions.We utilized a 3D T2 relaxation
sequence to follow MWF, WC, GMT2 and also
measured T1 on a monthly basis to
elucidate the time course of pathological changes in
new MS lesions. The behaviour of new lesions varied
between subjects, with some lesions showing
recovery. WC and MWF can monitor the evolution of
demyelination and remyelination in MS. |
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17:24 |
344. |
Whole-Brain Voxel-Wise
Analysis of Myelin Water Volume Fraction in Multiple
Sclerosis |
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Sean CL Deoni1
1Centre for Neuroimaging Sciences, London, UK |
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The ability to
distinguish affected, but normal appearing, white
matter tissue has significant clinical application
to MS and other de-myelinating disorders. Currently,
this may be accomplished using histogram analysis,
but at the expense of spatial information. Here we
demonstrate a patient-specific approach, involving
the comparison of voxel-wise myelin volume fraction
values, obtained using the mcDESPOT multi-component
relaxometry technique, to a reference
population-matched atlas. We demonstrate the ability
to visualize areas of significantly reduced myelin
fraction within tissue that appears normal on
conventional T1 or T2 weighted scans. |
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17:36 |
345. |
Differentiation of
Pathological Processes and Clinical Forms in
Multiple Sclerosis: A Tract Based Spatial Statistics
Study |
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Salem Hannoun1,2,
Francoise Durand-Dubief1,3, Danielle
Ibarrola2, Jean Christophe Comte2,
Christian Confavreux3, Dominique
Sappey-Marinier1,2
1CREATIS-LRMN, UMR5220 CNRS & U630 INSERM &
Université de Lyon, Bron, France; 2CERMEP-Imagerie
du vivant, Bron, France; 3Hopital
Neurologique, Groupement Hospitalier Est, Bron,
France |
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This study aims to
characterize the pathological processes and
differentiate the clinical forms of multiple
sclerosis (MS) patients using tract based spatial
statistics (TBSS). Significant decreases of FA
values were observed in numerous white matter
regions of MS patients (SP, PP and RR forms) when
compared to control subjects. These decreases were
also more pronounced when comparing patients with
more advanced forms (SP and PP) to RR patients while
no significant differences were observed between SP
and PP groups. This technique constitutes an
important new tool to follow the disease progression
and better characterize the alterations extent
between patients clinical status. |
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17:48 |
346. |
Application of Lesion
Probability Maps to Predict Progression in
Primary-Progressive Multiple Sclerosis: A 10-Year
Multi-Centre Study |
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Benedetta Bodini1,
Marco Battaglini2, Nicola De Stefano2,
Zhaleh Khaleeli1, Frederik Barkhof3,
Bruno Brochet4, Vincent Dousset5,
Massimo Filippi6, Xavier Montalban7,
Chris Polman3, Marco Rovaris6,
Alex Rovira7, Jaume Sastre-Garriga7,
David H. Miller8, Rebecca Samson8,
Olga Ciccarelli1, Alan J. Thompson1
1Dept. of Brain Repair and Rehabilitation,
Institute of Neurology, UCL, London, UK; 2Dept.
of Neurological and Behavioural Sciences, University
of Siena, Siena, Italy; 3Department of
Radiology, MS Center, VU University Medical Centre,
Amsterdam, Netherlands; 4Hopital
Pellegrin, Centre Hospitalier Universitaire,
Bordeaux, France; 5Bordeaux Neuroscience
Institute, University Victor Segalen, Bordeaux,
France; 6Neuroimaging Research Unit, San
Raffaele Scientific Institute, Milan, Italy; 7Depts.
of Neuroimmunology and Radiology, Hospital Vall
d’Hebron, Barcelona, Spain; 8Dept. of
Neuroinflammation, Institute of Neurology, UCL,
London, London, UK |
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The aim of this study
was to assess whether the spatial distribution of T2
lesions predicted long-term progression in primary
progressive multiple sclerosis (PPMS). To clarify
this issue, we applied Lesion Probability Map, a
novel technique, to a large cohort of PPMS patients
followed-up over 10 years. We found that the spatial
distribution of T2 lesions at baseline was relevant
in predicting the risk of long-term progression. In
particular, lesions in the motor and associative
tracts correlated with more rapid clinical
progression. We confirmed that male gender was
associated with a worse long-term prognosis. |
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