Long-term dynamics of multiple sclerosis iron rim lesions / Claudia E. Weber, Matthias Wittayer, Matthias Kraemer, Andreas Dabringhaus, Kathrin Bail, Michael Platten, Lucas Schirmer, Achim Gass, Philipp Eisele

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..

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:57

Enthalten in:

Multiple Sclerosis and Related Disorders - 57(2022), Artikel-ID 103340, Seite 1-10

Sprache:

Englisch

Beteiligte Personen:

Weber, Claudia Ellen, 1986- [VerfasserIn]
Wittayer, Matthias Sebastian, 1988- [VerfasserIn]
Kraemer, Matthias [VerfasserIn]
Dabringhaus, Andreas [VerfasserIn]
Bail, Kathrin, 1992- [VerfasserIn]
Platten, Michael, 1971- [VerfasserIn]
Schirmer, Lucas, 1981- [VerfasserIn]
Gass, Achim, 1961- [VerfasserIn]
Eisele, Philipp, 1982- [VerfasserIn]

Links:

Volltext [lizenzpflichtig]

Themen:

Brain
Chronic active lesions
Humans
Iron
Iron rim lesions
MRI
Magnetic Resonance Imaging
Multiple Sclerosis
Multiple sclerosis
Retrospective Studies
SWI

Anmerkungen:

Available online 18 October 2021

Gesehen am 02.09.2022

Umfang:

10

doi:

10.1016/j.msard.2021.103340

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

1815707593

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