Initial investigation of the blood-brain barrier in MS lesions at 7 tesla

María I. Gaitán, Pascal Sati, Souheil J. Inati, Daniel S. Reich

Research output: Contribution to journalArticlepeer-review

Abstract

Background: We previously described two dynamics of contrast enhancement in scans of active multiple sclerosis lesions: Medium-sized, early lesions enhance centrifugally, whereas larger, slightly older lesions enhance centripetally. Due to technical limitations, our previous study did not characterize lesions < 5 mm in diameter, cortical enhancement, and anatomical structures within lesions. Objective: The objective of this paper is to obtain initial observations of these important aspects of lesion development on a 7 tesla scanner at high spatial resolution. Methods: We scanned eight patients, acquiring precontrast T2*-weighted scans, T1-weighted scans before and after contrast, and high-resolution dynamic contrast-enhanced scans during and up to 30 min after contrast. Results: We detected 15 enhancing lesions, obtaining dynamic data in 10: Five lesions < 4 mm enhanced centrifugally (initial central enhancement expanded outward), and five lesions > 4 mm enhanced centripetally (initial peripheral enhancement gradually filled the lesion). A leukocortical lesion initially showed enhancement in its white matter portion, which gradually spread into the cortex. Seventy-three percent of lesions were clearly perivenular. Conclusion: Most active lesions are perivenular, and the smallest lesions enhance centrifugally. This supports the idea that lesions grow outward from a central vein.

Original languageEnglish (US)
Pages (from-to)1068-1073
Number of pages6
JournalMultiple Sclerosis Journal
Volume19
Issue number8
DOIs
StatePublished - Jul 2013

Keywords

  • 7 tesla
  • Veins
  • blood-brain barrier
  • contrast-enhancing lesions
  • magnetic resonance imaging
  • susceptibility weighted imaging

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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