Identical lesion morphology in primary progressive and relapsing-remitting MS - an ultrahigh field MRI study

In this study the researchers analysed the frequency, morphology and distribution of focal white and grey matter pathology in patients with primary progressive multiple sclerosis (PPMS) versus relapsing remitting multiple sclerosis (RRMS) through ultrahigh field MRI to establish if they appear different.

Nine PPMS patients and nine age- and gender-matched RRMS patients were investigated. Images were acquired using a 7 T whole body MR system. Imaging protocol included a two-dimensional axial T2 w fast low angle (FLASH). Visual analysis was performed using OsiriX and its integrated region of interest (ROI) function. Images were analysed by two experienced observers blinded to clinical data. Lesions were characterized by their morphology (central vein, hypointense rim), appearance (ovoid, circular, trapezoid, complex-shaped, or confluent), and maximum diameter. Lesion count, shape, location or spatial distribution were described as well.

The finding that a central vein is often visible in PPMS and RRMS lesions is in line with previous ultrahigh field MRI studies and ex vivo histological reports, suggesting that perivascular inflammation plays a key role in both, RRMS and PPMS. No differences between PPMS and RRMS regarding lesion count, shape, location, or spatial distribution were observed. However, lesion diameter was significantly higher in RRMS. The majority of both RRM and PPMS lesions was characterized by a central vein, commonly considered to be typical of MS. However, the study was limited by the low sample.

Authors: Kuchling J, Ramien C.
Source: Mult Scler. 2014 Apr 29. [Epub ahead of print]
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