Paramagnetic rims are a promising diagnostic imaging biomarker in multiple sclerosis
Meaton, Isobel (University of Nottingham)
Altokhis, Amjad (University of Nottingham)
Allen, Christopher Martin (University of Nottingham)
Clarke, Margareta A. (Vanderbilt University)
Sinnecker, Timm (University Basel)
Meier, Dominik (University Basel)
Enzinger, Christian (Medical University of Graz)
Calabrese, Massimiliano (University of Verona)
De Stefano, Nicola (University of Siena)
Pitiot, Alain (Laboratory of Image and Data Analysis (Regne Unit))
Giorgio, Antonio (University of Siena)
Schoonheim, Menno M. (Universiteit Amsterdam)
Paul, Friedemann (Charité - Universitätsmedizin Berlin)
Pawlak, Mikolaj A. (Poznan University of Medical Sciences)
Schmidt, Reinhold (Medical University of Graz)
Granziera, Cristina (University of Basel)
Kappos, Ludwig (University of Basel)
Montalban, Xavier (Hospital Universitari Vall d'Hebron)
Rovira, Alex (Hospital Universitari Vall d'Hebron)
Wuerfel, Jens (Charité - Universitätsmedizin Berlin)
Evangelou, Nikos (University of Nottingham)
Universitat Autònoma de Barcelona

Fecha:	2022
Resumen:	White matter lesions (WMLs) on brain magnetic resonance imaging (MRI) in multiple sclerosis (MS) may contribute to misdiagnosis. In chronic active lesions, peripheral iron-laden macrophages appear as paramagnetic rim lesions (PRLs). To evaluate the sensitivity and specificity of PRLs in differentiating MS from mimics using clinical 3T MRI scanners. This retrospective international study reviewed MRI scans of patients with MS (n = 254), MS mimics (n = 91) and older healthy controls (n = 217). WMLs, detected using fluid-attenuated inversion recovery MRI, were analysed with phase-sensitive imaging. Sensitivity and specificity were assessed for PRLs. At least one PRL was found in 22. 9% of MS and 26. 1% of clinically isolated syndrome (CIS) patients. Only one PRL was found elsewhere. The identification of ⩾1 PRL was the optimal cut-off and had high specificity (99. 7%, confidence interval (CI) = 98. 20%-99. 99%) when distinguishing MS and CIS from mimics and healthy controls, but lower sensitivity (24. 0%, CI = 18. 9%-36. 6%). All patients with a PRL showing a central vein sign (CVS) in the same lesion (n = 54) had MS or CIS, giving a specificity of 100% (CI = 98. 8%-100. 0%) but equally low sensitivity (21. 3%, CI = 16. 4%-26. 81%) PRLs may reduce diagnostic uncertainty in MS by being a highly specific imaging diagnostic biomarker, especially when used in conjunction with the CVS.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Multiple sclerosis ; MRI ; CIS ; Biomarkers
Publicado en:	Multiple sclerosis, Vol. 28 (august 2022) , p. 2212-2220, ISSN 1477-0970

DOI: 10.1177/13524585221118677
PMID: 36017870

9 p, 1.1 MB

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