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