Contributions
Abstract: P481
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - MRI and PET
Background: Leptomeningeal gadolinium enhancement lesions (LGEL) are the expression of the chronic meningeal inflammation of several inflammatory diseases of the central nervous system. LGEL have been described in multiple sclerosis, mainly in the progressive MS forms, but there are contradictory results on the impact of LGEL in brain atrophy phenomena.
Objective: To explore the relationship between LGEL and global and regional (grey/white matter atrophy, thalami, amygdalae, cerebellum) brain volume.
Methods: This is a transversal study over a consecutive series of MS patients studied with the following 3.0T MR images sequences: 3D T1-weighted images were acquired 5 minutes before and immediately after a single dose of intravenous bolus of 0.1 mmol/kg gadolinium injection, 3D-FLAIR for enhanced lesion detection (3D-FLAIRED) sequence was acquired 10 min post-contrast. Additional pre-contrast sequences included 2D T2/PD-WI and 3D high-resolution T1-WI. This latter sequence was used for measuring the brain volume measures with FreeSurfer. LGEL were defined as the presence of enhancement on the surface of the cortex only in the 3D-FLAIRED when comparing with the post-contrast T1 weighted images.
Results: One hundred and forty-six MS patients (67.1% females) were analysed. Demographic characteristics included: mean age 44.1 (SD 10.3); 13.5 (SD 9.5) years of evolution; mean EDSS 2.8 (SD 1.); mean MSSS 3.3 (2.3). Patients were divided into relapsing-remitting (101 patients, 69.2%) and progressive (36 secondary progressive MS, 24.7%; 9 primary progressive MS, 6.2%). LGEL presence was observed in 38 patients (26%); 15 of them in the SPMS form (p=0.038). We calculated the normalized brain volume (mean 1437.7, SD 153.0) and brain parenchymal fraction (mean 69.1 SD 4.5), the cortex volume (mean 420.5, SD 47.7), the total grey matter volume (mean 567.9, SD 60.5), the total white matter volume (mean 405..8, SD 62.1) and the volume of thalami (mean 12.3, SD 1.9), amygdalae (mean 3.0, SD .4) and cerebellum (mean 123.2, SD 15.7). No differences in all these brain volume measurements between patients with and without LGEL were found.
Conclusions: LGEL presence was more frequent in SPMS, but no relation with clinical or brain volume measurements was observed. Despite this, the presence of LGEL could be a radiological sign for detecting a secondary progressive course.
Disclosure: We declare not conflict of interest
Abstract: P481
Type: Poster Sessions
Abstract Category: Pathology and pathogenesis of MS - MRI and PET
Background: Leptomeningeal gadolinium enhancement lesions (LGEL) are the expression of the chronic meningeal inflammation of several inflammatory diseases of the central nervous system. LGEL have been described in multiple sclerosis, mainly in the progressive MS forms, but there are contradictory results on the impact of LGEL in brain atrophy phenomena.
Objective: To explore the relationship between LGEL and global and regional (grey/white matter atrophy, thalami, amygdalae, cerebellum) brain volume.
Methods: This is a transversal study over a consecutive series of MS patients studied with the following 3.0T MR images sequences: 3D T1-weighted images were acquired 5 minutes before and immediately after a single dose of intravenous bolus of 0.1 mmol/kg gadolinium injection, 3D-FLAIR for enhanced lesion detection (3D-FLAIRED) sequence was acquired 10 min post-contrast. Additional pre-contrast sequences included 2D T2/PD-WI and 3D high-resolution T1-WI. This latter sequence was used for measuring the brain volume measures with FreeSurfer. LGEL were defined as the presence of enhancement on the surface of the cortex only in the 3D-FLAIRED when comparing with the post-contrast T1 weighted images.
Results: One hundred and forty-six MS patients (67.1% females) were analysed. Demographic characteristics included: mean age 44.1 (SD 10.3); 13.5 (SD 9.5) years of evolution; mean EDSS 2.8 (SD 1.); mean MSSS 3.3 (2.3). Patients were divided into relapsing-remitting (101 patients, 69.2%) and progressive (36 secondary progressive MS, 24.7%; 9 primary progressive MS, 6.2%). LGEL presence was observed in 38 patients (26%); 15 of them in the SPMS form (p=0.038). We calculated the normalized brain volume (mean 1437.7, SD 153.0) and brain parenchymal fraction (mean 69.1 SD 4.5), the cortex volume (mean 420.5, SD 47.7), the total grey matter volume (mean 567.9, SD 60.5), the total white matter volume (mean 405..8, SD 62.1) and the volume of thalami (mean 12.3, SD 1.9), amygdalae (mean 3.0, SD .4) and cerebellum (mean 123.2, SD 15.7). No differences in all these brain volume measurements between patients with and without LGEL were found.
Conclusions: LGEL presence was more frequent in SPMS, but no relation with clinical or brain volume measurements was observed. Despite this, the presence of LGEL could be a radiological sign for detecting a secondary progressive course.
Disclosure: We declare not conflict of interest