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Improved Turnaround Times | Median time to first decision: 12 days

Research ArticleAdult Brain
Open Access

Value of 3T Susceptibility-Weighted Imaging in the Diagnosis of Multiple Sclerosis

M.A. Clarke, D. Pareto, L. Pessini-Ferreira, G. Arrambide, M. Alberich, F. Crescenzo, S. Cappelle, M. Tintoré, J. Sastre-Garriga, C. Auger, X. Montalban, N. Evangelou and À. Rovira
American Journal of Neuroradiology June 2020, 41 (6) 1001-1008; DOI: https://doi.org/10.3174/ajnr.A6547
M.A. Clarke
aFrom the Vall d′Hebron Research Institute (M.A.C., D.P., M.A., M.T., J.S.-G., C.A., X.M., A.R.), Barcelona, Spain
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D. Pareto
aFrom the Vall d′Hebron Research Institute (M.A.C., D.P., M.A., M.T., J.S.-G., C.A., X.M., A.R.), Barcelona, Spain
bSection of Neuroradiology, Department of Radiology (D.P., L.P.-F., C.A., A.R.), Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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L. Pessini-Ferreira
bSection of Neuroradiology, Department of Radiology (D.P., L.P.-F., C.A., A.R.), Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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G. Arrambide
cDepartment of Neurology-Neuroimmunology (G.A., M.T., J.S.-G., X.M.), Centre d’Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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M. Alberich
aFrom the Vall d′Hebron Research Institute (M.A.C., D.P., M.A., M.T., J.S.-G., C.A., X.M., A.R.), Barcelona, Spain
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F. Crescenzo
dDepartment of Neurosciences, Biomedicine and Movement Sciences (F.C.), University of Verona, Verona, Italy
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S. Cappelle
eDivision of Radiology (S.C.), University Hospital Leuven, Leuven, Belgium
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M. Tintoré
aFrom the Vall d′Hebron Research Institute (M.A.C., D.P., M.A., M.T., J.S.-G., C.A., X.M., A.R.), Barcelona, Spain
cDepartment of Neurology-Neuroimmunology (G.A., M.T., J.S.-G., X.M.), Centre d’Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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J. Sastre-Garriga
aFrom the Vall d′Hebron Research Institute (M.A.C., D.P., M.A., M.T., J.S.-G., C.A., X.M., A.R.), Barcelona, Spain
cDepartment of Neurology-Neuroimmunology (G.A., M.T., J.S.-G., X.M.), Centre d’Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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C. Auger
aFrom the Vall d′Hebron Research Institute (M.A.C., D.P., M.A., M.T., J.S.-G., C.A., X.M., A.R.), Barcelona, Spain
bSection of Neuroradiology, Department of Radiology (D.P., L.P.-F., C.A., A.R.), Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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X. Montalban
aFrom the Vall d′Hebron Research Institute (M.A.C., D.P., M.A., M.T., J.S.-G., C.A., X.M., A.R.), Barcelona, Spain
cDepartment of Neurology-Neuroimmunology (G.A., M.T., J.S.-G., X.M.), Centre d’Esclerosi Múltiple de Catalunya (Cemcat), Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
fDivision of Neurology (X.M.), St. Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada
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N. Evangelou
gDivision of Clinical Neuroscience (N.E.), University of Nottingham, Nottingham, UK.
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À. Rovira
aFrom the Vall d′Hebron Research Institute (M.A.C., D.P., M.A., M.T., J.S.-G., C.A., X.M., A.R.), Barcelona, Spain
bSection of Neuroradiology, Department of Radiology (D.P., L.P.-F., C.A., A.R.), Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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    Fig 1.

    Patient flow diagram showing how patients were selected for the study and the reasons for exclusion. We excluded patients for the following reasons: 1) missing either their SWI or T2-FLAIR scan; 2) lesions <3 mm or infratentorial lesions that could not be identified on the SWI due to artifacts; 3) automated lesion masks not passing quality checks; and 4) diagnostic doubt by the end of the study follow-up. RRMS indicates relapsing-remitting multiple sclerosis.

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    Fig 2.

    Lesion appearance on axial T2-FLAIR (upper row) and the corresponding susceptibility-weighted (lower row) images in patients with Sjögren disease (A and C) and MS (B and D). The patient with Sjögren disease has no visible CVs or IRs on the SWI. The patient with MS has clearly visible IRs, which correspond to the lesion edges visible on the T2-FLAIR. CVs are also visible inside the lesions as hypointense dots or lines.

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    Fig 3.

    The location of lesions with central veins in the CIS and non-MS groups. Error bars represent standard error.

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    Fig 4.

    Summary of the incidence of lesions with CVs in the CIS and non-MS groups. A, The number of lesions with CVs (per patient) in the 2 groups. B, The percentage of lesions with CVs (per patient) in the 2 groups.

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    Fig 5.

    Summary of the incidence of lesions with iron rings in the CIS and non-MS groups. A, The number of lesions with iron rings (per patient) in the 2 groups. B, The location of lesions with iron rings in the CIS group.

Tables

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  • Demographic and clinical data of the patients included in the study

    CIS Group (n = 112)Non-MS Group (n = 35)
    Mean age (SD, range) (yr)35.4 (7.9, 19–49)41.7 (11.5, 20–67)
    Sex, female No. (%)70 (70.5%)23 (65.7%)
    Clinical diagnosis at the end of the study No. (%)MS = 94 (83.9%) (including CDMS = 42 [37.5%]) CIS = 18 (16.1%)Autoimmune disease = 13 (37.1%)Vascular disease = 8 (22.9%)Incidental findings = 1 (2.9%)Infectious disease = 1 (2.9%)Headache = 3 (8.6%)Other = 9 (25.7%)
    +/− OCBs No. (not performed)80/21 (11)2/15 (18)
    Median EDSS (range)1.5 (0–4.5)NA
    Median WM lesion No. (range)4 (1–31)7 (1–31)
    • Note:—EDSS indicates Expanded Disability Status Scale; NA, not available.

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American Journal of Neuroradiology: 41 (6)
American Journal of Neuroradiology
Vol. 41, Issue 6
1 Jun 2020
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Cite this article
M.A. Clarke, D. Pareto, L. Pessini-Ferreira, G. Arrambide, M. Alberich, F. Crescenzo, S. Cappelle, M. Tintoré, J. Sastre-Garriga, C. Auger, X. Montalban, N. Evangelou, À. Rovira
Value of 3T Susceptibility-Weighted Imaging in the Diagnosis of Multiple Sclerosis
American Journal of Neuroradiology Jun 2020, 41 (6) 1001-1008; DOI: 10.3174/ajnr.A6547

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Value of 3T Susceptibility-Weighted Imaging in the Diagnosis of Multiple Sclerosis
M.A. Clarke, D. Pareto, L. Pessini-Ferreira, G. Arrambide, M. Alberich, F. Crescenzo, S. Cappelle, M. Tintoré, J. Sastre-Garriga, C. Auger, X. Montalban, N. Evangelou, À. Rovira
American Journal of Neuroradiology Jun 2020, 41 (6) 1001-1008; DOI: 10.3174/ajnr.A6547
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