Sistema de Salut de Catalunya
Institut Català de la Salut
[Meaton I, Altokhis A, Allen CM] Mental Health and Clinical Neurosciences Academic Unit, School of Medicine, University of Nottingham, Nottingham, UK. [Clarke MA] Institute of Imaging Science, Vanderbilt University Medical Center, Vanderbilt University, Nashville, TN, USA. [Sinnecker T, Meier D] Medical Image Analysis Center AG and Department of Biomedical Engineering, University Basel, Basel, Switzerland. [Montalban X] Servei de Neurologia-Neuroimmunologia, Centre d’Esclerosi Múltiple de Catalunya (CEMCAT), Barcelona, Spain. Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [Rovira À] Secció de Neurorradiologia, Servei de Radiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain
Vall d'Hebron Barcelona Hospital Campus
2022-12-13T12:48:01Z
2022-12-13T12:48:01Z
2022-12
MRI; Multiple sclerosis; Biomarkers
Ressonància magnètica; Esclerosi múltiple; Biomarcadors
Resonancia magnética; Esclerosis múltiple; Biomarcadores
Background: 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). Objective: To evaluate the sensitivity and specificity of PRLs in differentiating MS from mimics using clinical 3T MRI scanners. Method: 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. Results: 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%) Conclusion: PRLs may reduce diagnostic uncertainty in MS by being a highly specific imaging diagnostic biomarker, especially when used in conjunction with the CVS.
Article
Published version
English
Esclerosi múltiple - Imatgeria; Marcadors bioquímics; Mielina - Malalties; DISEASES::Nervous System Diseases::Autoimmune Diseases of the Nervous System::Demyelinating Autoimmune Diseases, CNS::Multiple Sclerosis; Other subheadings::Other subheadings::Other subheadings::/diagnostic imaging; CHEMICALS AND DRUGS::Biological Factors::Biomarkers; DISEASES::Nervous System Diseases::Demyelinating Diseases; ENFERMEDADES::enfermedades del sistema nervioso::enfermedades autoinmunitarias del sistema nervioso::enfermedades autoinmunes desmielinizantes del SNC::esclerosis múltiple; Otros calificadores::Otros calificadores::Otros calificadores::/diagnóstico por imagen; COMPUESTOS QUÍMICOS Y DROGAS::factores biológicos::biomarcadores; ENFERMEDADES::enfermedades del sistema nervioso::enfermedades desmielinizantes
SAGE Publications
Multiple Sclerosis Journal;28(14)
https://doi.org/10.1177/13524585221118677
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
Articles científics - CEMCAT [136]
Articles científics - HVH [3396]
