Long-term dynamics of multiple sclerosis iron rim lesions

• Verfasst von: Weber, Claudia Ellen [VerfasserIn]
• Verfasst von: Wittayer, Matthias Sebastian [VerfasserIn]
• Verfasst von: Kraemer, Matthias [VerfasserIn]
• Verfasst von: Dabringhaus, Andreas [VerfasserIn]
• Verfasst von: Bail, Kathrin [VerfasserIn]
• Verfasst von: Platten, Michael [VerfasserIn]
• Verfasst von: Schirmer, Lucas [VerfasserIn]
• Verfasst von: Gass, Achim [VerfasserIn]
• Verfasst von: Eisele, Philipp [VerfasserIn]
• Titel: Long-term dynamics of multiple sclerosis iron rim lesions
• Verf.angabe: Claudia E. Weber, Matthias Wittayer, Matthias Kraemer, Andreas Dabringhaus, Kathrin Bail, Michael Platten, Lucas Schirmer, Achim Gass, Philipp Eisele
• Jahr: 2022
• Umfang: 10 S.
• Fussnoten: Available online 18 October 2021 ; Gesehen am 02.09.2022
• Titel Quelle: Enthalten in: Multiple Sclerosis and Related Disorders
• Ort Quelle: Amsterdam [u.a.] : Elsevier, 2012
• Jahr Quelle: 2022
• Band/Heft Quelle: 57(2022), Artikel-ID 103340, Seite 1-10
• ISSN Quelle: 2211-0356
• DOI: doi:10.1016/j.msard.2021.103340
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Brain
• Sach-SW: Chronic active lesions
• Sach-SW: Humans
• Sach-SW: Iron
• Sach-SW: Iron rim lesions
• Sach-SW: Magnetic Resonance Imaging
• Sach-SW: MRI
• Sach-SW: Multiple sclerosis
• Sach-SW: Multiple Sclerosis
• Sach-SW: Retrospective Studies
• Sach-SW: SWI
• K10plus-PPN: 1815707593

Abstract

BACKGROUND: Several studies have pointed out that seemingly chronic multiple sclerosis (MS) lesions may also be in inflammatory states. In pathological studies, up to 40% of chronic MS lesions are characterized as "chronic active" or "smoldering" lesions that are characterized by a rim of iron-laden proinflammatory macrophages/microglial cells at the lesion edge with low-grade continuous myelin breakdown. In vivo, these lesions can be visualized as "iron rim lesions" (IRLs) on susceptibility-weighted imaging (SWI). The aim of this study was to investigate the long-term dynamics of IRLs in vivo for a more detailed evolution of dynamic lesion volume changes occurring over time. - METHODS: We retrospectively identified patients with MS who were followed for at least 36 months (up to 72 months) and underwent at least an annual MRI on the same 3 Tsystem. Using Voxel-Guided Morphometry (VGM) we investigated regional volume changes within lesions and correlated these findings with SWI for the presence of a characteristic hypointense lesion rim. To estimate tissue damage, apparent diffusion coefficient (ADC) values for every lesion at baseline and follow-up MRIs were determined. - RESULTS: Forty-three patients were included in the study. Overall, we identified 302 supratentorial non-confluent MS lesions (52 persistent IRLs, nine transient IRLs, 228 non-IRLs and 13 acute contrast-enhancing lesions). During follow-up, persistent IRLs significantly enlarged, whereas non-IRLs showed a tendency to shrink. At baseline MRI, ADC values were significantly higher in persistent IRLs (1.23 × 10-3 mm/s2) compared to non-IRLs (1.01 × 10-3 mm/s2; p < 0.001), but not compared to transient IRLs (1.06 × 10-3 mm/s2; p = 0.15) and contrast-enhancing lesions (1.15 × 10-3 mm/s2; p = 1.0). During follow-up, ADC values significantly increased more often in persistent IRLs compared to all other lesion types (p < 0.0001). - CONCLUSIONS: Our long-term data demonstrate that persistent IRLs enlarge during disease duration, whereas non-IRLs show a tendency to shrink. Furthermore, IRLs are associated with sustained tissue damage, supporting the notion that IRLs could represent a new imaging biomarker in MS.