%0 Journal Article
%T Ultrahigh-Field MR (7£¿T) Imaging of Brain Lesions in Neuromyelitis Optica
%A Ilya Kister
%A Joseph Herbert
%A Yongxia Zhou
%A Yulin Ge
%J Multiple Sclerosis International
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/398259
%X Background. Brain lesions are common in neuromyelitis optica spectrum disorder (NMOsd) and may resemble lesions of multiple sclerosis (MS). Objectives. To describe the imaging characteristics of supratentorial lesions in NMOsd on ultrahigh-field (7£¿T) MRI with special attention to vessel-lesion relationship. Methods. Ten NMOsd patients, all women and all seropositive for NMO IgG, with mean age of 51.3 ¡À 15.4 years and disease duration of 9.2 ¡À 6.4 years, were scanned at a 7£¿T whole-body human MR system with high-resolution 2D gradient echo sequence optimized to best visualize lesions and venous structures, T2- and T1-weighted imaging. Results. In 10 patients with NMOsd, a total of 92 lesions were observed (mean: 9.2 ¡À 8.8; range: 2¨C30), but only 8 lesions (9%) were traversed by a central venule. All lesions were <5£¿mm in diameter, and 83% were located in subcortical white matter. There were no lesions in the cortex or basal ganglia. Two patients exhibited diffuse periependymal abnormalities on FLAIR. Conclusions. Small, subcortical lesions without a central venule are the most consistent finding of NMOsd on 7£¿T MRI of the brain. Ultrahigh-field imaging may be useful for differentiating between NMOsd and MS. 1. Introduction Neuromyelitis optica (NMO) has been traditionally considered a predominantly opticospinal disorder, but recent studies have shown that clinical spectrum of NMO includes cerebral and brainstem syndromes as well [1¨C3]. Brain lesions on magnetic resonance imaging (MRI) are found in the majority of NMO patients with long-standing disease [1, 2, 4¨C6], which makes it sometimes difficult to differentiate this disorder from multiple sclerosis (MS). Ultrahigh-field MRI (4 Tesla or above) affords an unprecedented view of brain structures and pathology in vivo on a submillimeter scale due to high signal-to-noise ratio [7, 8]. The largely enhanced susceptibility of ultrahigh-field MR effect provides unique contrast between lesions and veins. This feature makes ultrahigh-field MR a valuable tool for differentiating plaques of MS, which frequently contain a venule, from lesions of other etiologies that rarely do [9]. Our aim in this work is to characterize brain lesions in patients with neuromyelitis optica spectrum disorders (NMOsd) using 7£¿T MR and to discuss the findings in the context of the growing literature on ultrahigh-field imaging in MS [9¨C19]. 2. Methods Inclusion criteria in the study were the diagnosis of NMO-spectrum disorders (NMOsd) defined either as NMO by 2006 Wingerchuk et al. criteria [20], or recurrent longitudinally extensive
%U http://www.hindawi.com/journals/msi/2013/398259/