Contributions
Abstract: EP1517
Type: ePoster
Abstract Category: Pathology and pathogenesis of MS - 21 Imaging
Background: Abnormal MRI findings in spinal cord (SC) frequently occur in multiple sclerosis (MS). However, the relationship between lesions, diffuse pathology and SC atrophy in different MS phenotypes remains poorly understood.
Objective: To investigate spinal cord pathology in different MS phenotypes with 3T MRI.
Methods: We evaluated cervical and upper thoracic SC of 1,036 MS patients (739 women, 295 men) using the uniform MRI protocols: T2-weighted image with fat suppression (T2WI- Fat- Sat) in sagittal (slice thickness 2.0/0 mm) and 3D-T2WI-Fat-Sat in transversal plane 3D. There were 169 patients with clinically isolated syndrome (CIS), 743 relapse remitting (RRMS) patients and 124 secondary progressive MS (SPMS). The spinal cord volume (SCV) was measured semi automatically in 21 slices centered at intervertebral disc C3/C4. Lesion number and location (between craniocervical junction and vertebral body Th4) and presence of diffuse changes were evaluated by a neuroradiologist.
Results: Normally appearing SC was present in 33.7% (347 patients: CIS 45%, RRMS 33%, SPMS 19%). Diffuse abnormalities were present in 48 CIS (28%), 307 RRMS (41%) and 66 SPMS patients (54%). Focal lesions were described in 110 CIS (35%), 454 RRMS (39%) and 67 SPMS patients (54%). The mean of SCV (between vertebral body C3-C4): was 1.84 cm3 (SD 0.18) in CIS, 1.76 cm3 (SD 0.20) in RRMS and 1.64 cm3 (SD 0.21) in SPMS. Statistically significant differences in SCV and type of SC pathology were found among all three groups (p< 0.001) (adjusted for gender, age, disease duration). The maximum effect size was 0.15 for combination of diffuse changes and lesions and 0.14 for whole diffuse changes. The mean of SCV differed significantly between men (1.83 cm3) and women
(1.74 cm3). Interestingly, this effect declined with disability and men with SPMS had even smaller SCV (1.63 cm3) than women with SPMS (1.64 cm3).
Conclusions: This large dataset of 3T MRI derived from an academic MS clinic represents well a variety of SC abnormalities present in different MS phenotypes. Incidence of diffuse abnormalities in spinal cord on MR increases with severity of the disease. Diffuse abnormalities may be an important discriminator between disease phenotypes, which should be evaluated in longitudinal studies. In SPMS, SC atrophy was more pronounced in men, suggesting sex differences in pathophysiology of SCV loss.
Disclosure: The project was supported by the Czech Ministry of Education project Progres Q27/LF1, by the Czech Ministry of Health project RVO-VFN64165. Funding for bio statistical support was provided by Novartis
Manuela Vaneckova received compensation for travel, speaker honoraria and consultant fees from Biogen Idec, Novartis and Sanofi Genzyme, as well as support for research activities from Biogen Idec.
Michaela Andelova has received travel support from Novartis and Biogen
Jan Krasensky has received research funding from Biogen.
Lukas Sobisek received financial support from Novartis
Zdenek Seidl has received research funding from Biogen.
Tomas Uher received financial support for conference travel and honoraria from Biogen Idec, Roche, Novartis, Genzyme and Merck Serono, as well as support for research activities from Biogen Idec.
Eva Havrdova received speaker honoraria and consultant fees from Biogen Idec, Merck Serono, Novartis, Genzyme and Teva, as well as support for research activities from Biogen Idec and Merck Serono.
Jana Lizrova Preiningerova received compensation for travel and speaker honoraria from Biogen Idec, Novartis, Merck Serono, Sanofi Genzyme and support for research activities from Biogen Idec.
Barbora Benova received compensation for travelling and conference fees from Novartis, Sanofi Genzyme and Biogen Idec.
Tereza Hrebikova whitout any support
Dana Horakova received compensation for travel, speaker honoraria and consultant fees from Biogen Idec, Novartis, Merck, Bayer, Sanofi Genzyme, and Teva, as well as support for research activities from Biogen Idec.
Abstract: EP1517
Type: ePoster
Abstract Category: Pathology and pathogenesis of MS - 21 Imaging
Background: Abnormal MRI findings in spinal cord (SC) frequently occur in multiple sclerosis (MS). However, the relationship between lesions, diffuse pathology and SC atrophy in different MS phenotypes remains poorly understood.
Objective: To investigate spinal cord pathology in different MS phenotypes with 3T MRI.
Methods: We evaluated cervical and upper thoracic SC of 1,036 MS patients (739 women, 295 men) using the uniform MRI protocols: T2-weighted image with fat suppression (T2WI- Fat- Sat) in sagittal (slice thickness 2.0/0 mm) and 3D-T2WI-Fat-Sat in transversal plane 3D. There were 169 patients with clinically isolated syndrome (CIS), 743 relapse remitting (RRMS) patients and 124 secondary progressive MS (SPMS). The spinal cord volume (SCV) was measured semi automatically in 21 slices centered at intervertebral disc C3/C4. Lesion number and location (between craniocervical junction and vertebral body Th4) and presence of diffuse changes were evaluated by a neuroradiologist.
Results: Normally appearing SC was present in 33.7% (347 patients: CIS 45%, RRMS 33%, SPMS 19%). Diffuse abnormalities were present in 48 CIS (28%), 307 RRMS (41%) and 66 SPMS patients (54%). Focal lesions were described in 110 CIS (35%), 454 RRMS (39%) and 67 SPMS patients (54%). The mean of SCV (between vertebral body C3-C4): was 1.84 cm3 (SD 0.18) in CIS, 1.76 cm3 (SD 0.20) in RRMS and 1.64 cm3 (SD 0.21) in SPMS. Statistically significant differences in SCV and type of SC pathology were found among all three groups (p< 0.001) (adjusted for gender, age, disease duration). The maximum effect size was 0.15 for combination of diffuse changes and lesions and 0.14 for whole diffuse changes. The mean of SCV differed significantly between men (1.83 cm3) and women
(1.74 cm3). Interestingly, this effect declined with disability and men with SPMS had even smaller SCV (1.63 cm3) than women with SPMS (1.64 cm3).
Conclusions: This large dataset of 3T MRI derived from an academic MS clinic represents well a variety of SC abnormalities present in different MS phenotypes. Incidence of diffuse abnormalities in spinal cord on MR increases with severity of the disease. Diffuse abnormalities may be an important discriminator between disease phenotypes, which should be evaluated in longitudinal studies. In SPMS, SC atrophy was more pronounced in men, suggesting sex differences in pathophysiology of SCV loss.
Disclosure: The project was supported by the Czech Ministry of Education project Progres Q27/LF1, by the Czech Ministry of Health project RVO-VFN64165. Funding for bio statistical support was provided by Novartis
Manuela Vaneckova received compensation for travel, speaker honoraria and consultant fees from Biogen Idec, Novartis and Sanofi Genzyme, as well as support for research activities from Biogen Idec.
Michaela Andelova has received travel support from Novartis and Biogen
Jan Krasensky has received research funding from Biogen.
Lukas Sobisek received financial support from Novartis
Zdenek Seidl has received research funding from Biogen.
Tomas Uher received financial support for conference travel and honoraria from Biogen Idec, Roche, Novartis, Genzyme and Merck Serono, as well as support for research activities from Biogen Idec.
Eva Havrdova received speaker honoraria and consultant fees from Biogen Idec, Merck Serono, Novartis, Genzyme and Teva, as well as support for research activities from Biogen Idec and Merck Serono.
Jana Lizrova Preiningerova received compensation for travel and speaker honoraria from Biogen Idec, Novartis, Merck Serono, Sanofi Genzyme and support for research activities from Biogen Idec.
Barbora Benova received compensation for travelling and conference fees from Novartis, Sanofi Genzyme and Biogen Idec.
Tereza Hrebikova whitout any support
Dana Horakova received compensation for travel, speaker honoraria and consultant fees from Biogen Idec, Novartis, Merck, Bayer, Sanofi Genzyme, and Teva, as well as support for research activities from Biogen Idec.