Quantitative susceptibility mapping of multiple sclerosis lesions at various ages.
OBJECTIVE
To assess multiple sclerosis (MS) lesions at various ages by using quantitative susceptibility mapping (QSM) and conventional magnetic resonance (MR) imaging.


METHODS
Retrospectively selected were 32 clinically confirmed MS patients (nine men and 23 women; 39.3 years ± 10.9) who underwent two MR examinations (interval, 0.43 years ± 0.16) with three-dimensional gradient-echo sequence from August 2011 to August 2012. To estimate the ages of MS lesions, MR examinations performed 0.3-10.6 years before study examinations were studied. Hyperintensity on T2-weighted images was used to define MS lesions. QSM images were reconstructed from gradient-echo data. Susceptibility of MS lesions and temporal rates of change were obtained from QSM images. Lesion susceptibilities were analyzed by t test with intracluster correlation adjustment and Bonferroni correction in multiple comparisons.


RESULTS
MR imaging of 32 patients depicted 598 MS lesions, of which 162 lesions (27.1%) in 23 patients were age measurable and six (1.0%) were only visible at QSM. The susceptibilities relative to normal-appearing white matter (NAWM) were 0.53 ppb ± 3.34 for acute enhanced lesions, 38.43 ppb ± 13.0 (positive; P < .01) for early to intermediately aged nonenhanced lesions, and 4.67 ppb ± 3.18 for chronic nonenhanced lesions. Temporal rates of susceptibility changes relative to cerebrospinal fluid were 12.49 ppb/month ± 3.15 for acute enhanced lesions, 1.27 ppb/month ± 2.31 for early to intermediately aged nonenhanced lesions, and -0.004 ppb/month ± 0 for chronic nonenhanced lesions.


CONCLUSIONS
Magnetic susceptibility of MS lesions increased rapidly as it changed from enhanced to nonenhanced, it attained a high susceptibility value relative to NAWM during its initial few years (approximately 4 years), and it gradually dissipated back to susceptibility similar to that of NAWM as it aged, which may provide new insight into pathophysiologic features of MS lesions. Online supplemental material is available for this article.
From the Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China (W.C.); Departments of Neurology (S.A.G.) and Radiology (W.C., A.G., J.C., T.L., S.W., M.P., Y.W.), Weill Cornell Medical College, 515 E 71st St, New York, NY 10021; Department of Biomedical Engineering, Cornell University, Ithaca, NY (T.L., Y.W.); Department of Biomedical Engineering, Kyung Hee University, Seoul, South Korea (Y.W.); School of Electronic Engineering, University of Electronic Science and Technology of China, Chengdu, China (S.W.); and Department of Neurology, Yale University, New Haven, Conn (D.P.).
Weiwei
W
Chen
Susan A
SA
Gauthier
Ajay
A
Gupta
Joseph
J
Comunale
Tian
T
Liu
Shuai
S
Wang
Mengchao
M
Pei
David
D
Pitt
Yi
Y
Wang
D000328:Adult; D003287:Contrast Media; D005260:Female; D005682:Gadolinium; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000473:pathology*; D012189:Retrospective Studies
D003287:Contrast Media; D005682:Gadolinium