Article Figures & Data
Figures
- Fig 1.
Section stained with anti-proteolipid protein antibodies (A), matched with T2*WI (B) and T2WI (C and D). Note that the histologic section corresponds with multiple slices of the MR image; the top part of image B and D corresponds to the top part of image A, and the bottom part of image C corresponds to the bottom part of image A. The border between successive MR imaging slices is depicted by the blue dotted line. Lesions are indicated with arrows (WML is blue; GML is red). The type of GM lesion is indicated by I–IV. Also indicated is whether histologic lesions were retrospectively seen on MR imaging (asterisk) or missed on MR imaging (number sign). All other histologic lesions were prospectively detected. Degree of magnification: 50×.
- Fig 2.
An example of extensive cortical demyelination in an MS case. Histologic section with anti-proteolipid protein antibody (left) and a matched T2WI (right). The histologic section shows extensive cortical demyelination (lack of proteolipid protein) in the cortex, except for a small section at the left bottom (asterisk). This extensive demyelination makes it difficult to differentiate lesions and normal-appearing gray matter on MR imaging (right). In this particular case, as a result, prospective MR imaging scoring was negative. CC indicates corpus callosum. Degree of magnification: 50×.
Tables
Case No. Noa Sex Age (yr) PMD (h:min)b DD (yr) MS Type COD MS 1 M 80 6:05 45 SPMS Pneumonia 2 F 81 3:30 27 PPMS Pneumonia 3 M 75 10:10 50 NA Pneumonia 4 F 66 7:30 17 NA Pulmonary hypertension 5 M 71 4:00 15 SPMS Pulmonary carcinoma 6 F 54 6:00 16 SPMS Liver cancer 7 M 63 4:30 25 SPMS Pneumonia 8 M 78 3:00 33 SPMS Euthanasia 9 M 59 5:00 21 SPMS Euthanasia 10 M 56 10:10 13 NA Suicide 11 F 56 8:25 32 SPMS Pneumonia 12 F 54 3:30 31 SPMS Heart failure 13 M 58 4:00 27 SPMS Pneumonia 14 F 95 6:30 55 SPMS Unknown 15 F 81 6:30 21 SPMS Heart failure Mean 68.5 ± 12.7 5:56 ± 2:27 28.5 ± 12.9 Control 20 4 F 72 >24:00 – – Myocardial infarct 21 3 F 58 <24:00 – – Breast cancer 22 3 F 76 <24:00 – – Pneumonia 23 2 F 76 <8:00 – – Pneumonia Mean 70.5 ± 8.5 Note:—PMD indicates postmortem delay; DD, disease duration since diagnosis; SPMS, secondary-progressive MS; PPMS, primary-progressive MS; COD, cause of death; NA, unavailable/unknown; –, not applicable.
↵a The numbers indicate number of hemispheric sections included per case.
↵b Control cases are not part of the rapid postmortem examination program and therefore have a longer PMD.
Lesion Type Histology Prospective MRI Retrospective MRI Count T2WI T2*WI P Value T2WI T2*WI P Value I 14 8 (57) 2 (14) – 14 (100) 13 (93) – II 16 3 (19) 5 (31) – 13 (81) 10 (63) – III 43 5 (12) 5 (12) – 32 (74) 36 (84) – IV 25 11 (44) 4 (16) – 22 (88) 23 (92) – GML (I–IV) 98 27 (28) 16 (16) .054 81 (83) 82 (84) .803 GML (II–IV) 84 19 (23) 14 (17) .380 67 (80) 69 (82) 0.608 WML 7 6 (86) 3 (43) – 7 (100) 7 (100) – Total 105 33 (31) 19 (18) .018b 88 (84) 89 (85) .803 CNR T2WI T2*WI WM-WML 12.07 (0.90) 5.03 (1.68) GM-GML 2.01 (0.74) 1.7 (1.37) GM-WM 7.5 (1.58) 4.96 (3.79) Note:—WM-WML indicates white matter-to-white matter lesion CNR; GM-GML, gray matter-to-gray matter lesion CNR; GM-WM, gray matter-to-white matter CNR.
