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Paramagnetic Rims in Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder: A Quantitative Susceptibility Mapping Study with 3-T MRI

Journal of Clinical Neurology 2020년 16권 4호 p.562 ~ 572
장진희, 남윤호, 최양선, 신나영, 안재영, 안국진, 김범수, 이광수, 김우준,
소속 상세정보
장진희 ( Jang Jin-Hee ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Radiology
남윤호 ( Nam Yoon-Ho ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Radiology
최양선 ( Choi Yang-Sean ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Radiology
신나영 ( Shin Na-Young ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Radiology
안재영 ( An Jae-Young ) - Catholic University College of Medicine St. Vincent’s Hospital Department of Neurology
안국진 ( Ahn Kook-Jin ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Radiology
김범수 ( Kim Bum-Soo ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Radiology
이광수 ( Lee Kwang-Soo ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Neurology
김우준 ( Kim Woo-Jun ) - Catholic University College of Medicine Seoul St. Mary’s Hospital Department of Neurology

Abstract


Background and Purpose: Iron retained by activated microglia and macrophages in multiple sclerosis (MS) lesions may serve as a marker of innate immune system activation. Among several magnetic resonance imaging (MRI) methods, there has been recent interest in using quantitative susceptibility mapping (QSM) as a potential tool for assessing iron levels in the human brain. This study examined QSM findings in MS and neuromyelitis optica spectrum disorder (NMOSD) lesions obtained with 3-T MRI to assess imaging characteristics related to paramagnetic rims around brain lesions in MS and NMOSD.

Methods: This study included 32 MS and 21 seropositive NMOSD patients. MRI images were obtained using two 3-T MRI devices (Ingenia, Philips Healthcare; and Magnetom Verio, Siemens Healthineers) during routine diagnosis and treatment procedures. Multi and single echo gradient echo magnitude and phase images were obtained for QSM reconstruction. QSM images were used to characterize the detected lesions, and the findings were compared between MS and NMOSD.

Results: Totals of 71 and 35 MRI scans were performed during the study period in MS and NMOSD patients, respectively. In QSM images, paramagnetic rims were found in 26 (81.2%) MS patients and 1 (4.8%) NMOSD patient. Eight of the 22 MS patients and only 1 of the 10 NMOSD patients who underwent follow-up MRI showed new paramagnetic rims. The paramagnetic rim lesions appeared after enhancement or in new T2-weighted lesions without enhancement.

Conclusions: Paramagnetic rims might be a characteristic MRI finding for MS, and therefore they have potential as an imaging marker for differentially diagnosing MS from NMOSD using 3-T MRI.

키워드

multiple sclerosis; neuromyelitis optica spectrum disorder; quantitative susceptibility mapping; iron; demyelination; magnetic resonance imaging

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