title: Investigation of leptomeningeal enhancement in MS: a postcontrast FLAIR MRI study.
abstract: OBJECTIVE
  To investigate possible leptomeningeal contrast enhancement using postcontrast fluid-attenuated inversion recovery (FLAIR) MRI as an additional marker of inflammation in patients with multiple sclerosis (MS).
  
  
  METHODS
  A cohort of 112 patients (73 women) with clinically definitive MS or a clinically isolated syndrome suggestive of CNS demyelination were included. A pathologic control group of 5 stroke patients was also examined. MRI was performed on a 3T system including FLAIR, T2-weighted, T1-weighted-contrast injection, followed by T1-weighted and FLAIR.
  
  
  RESULTS
  Of the 112 patients, 39 had an acute relapse at the time of MRI. In total, 96 contrast-enhancing lesions were identified on postcontrast T1-weighted images. The pathologic control group demonstrated the sensitivity of postcontrast FLAIR images demonstrating leptomeningeal enhancement in all cases. In contrast, only 1 out of 112 examined patients with MS showed a single area of abnormal leptomeningeal contrast enhancement.
  
  
  CONCLUSIONS
  In contrast to intraparenchymal blood-brain barrier (BBB) dysfunction that is frequently seen in patients with MS, BBB dysfunction of leptomeningeal vessels is usually not detectable in patients with early MS.
authors.affiliation: From the Department of Neurology (P.E., M.G., K.S., M.E.W., A.A., M.G.H., A.G.), Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany; and Theodor Kocher Institute (B.E.), University of Bern, Switzerland.
authors.forename: Philipp
authors.initials: P
authors.lastname: Eisele
authors.affiliation: From the Department of Neurology (P.E., M.G., K.S., M.E.W., A.A., M.G.H., A.G.), Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany; and Theodor Kocher Institute (B.E.), University of Bern, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Griebe
authors.affiliation: From the Department of Neurology (P.E., M.G., K.S., M.E.W., A.A., M.G.H., A.G.), Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany; and Theodor Kocher Institute (B.E.), University of Bern, Switzerland.
authors.forename: Kristina
authors.initials: K
authors.lastname: Szabo
authors.affiliation: From the Department of Neurology (P.E., M.G., K.S., M.E.W., A.A., M.G.H., A.G.), Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany; and Theodor Kocher Institute (B.E.), University of Bern, Switzerland.
authors.forename: Marc E
authors.initials: ME
authors.lastname: Wolf
authors.affiliation: From the Department of Neurology (P.E., M.G., K.S., M.E.W., A.A., M.G.H., A.G.), Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany; and Theodor Kocher Institute (B.E.), University of Bern, Switzerland.
authors.forename: Angelika
authors.initials: A
authors.lastname: Alonso
authors.affiliation: From the Department of Neurology (P.E., M.G., K.S., M.E.W., A.A., M.G.H., A.G.), Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany; and Theodor Kocher Institute (B.E.), University of Bern, Switzerland.
authors.forename: Britta
authors.initials: B
authors.lastname: Engelhardt
authors.affiliation: From the Department of Neurology (P.E., M.G., K.S., M.E.W., A.A., M.G.H., A.G.), Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany; and Theodor Kocher Institute (B.E.), University of Bern, Switzerland.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Hennerici
authors.affiliation: From the Department of Neurology (P.E., M.G., K.S., M.E.W., A.A., M.G.H., A.G.), Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany; and Theodor Kocher Institute (B.E.), University of Bern, Switzerland. achim.gass@medma.uni-heidelberg.de.
authors.forename: Achim
authors.initials: A
authors.lastname: Gass
mesh_terms: D000328:Adult; D001812:Blood-Brain Barrier / Q000473:pathology*; D015331:Cohort Studies; D003287:Contrast Media; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008578:Meninges / Q000473:pathology*; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis*; D011446:Prospective Studies
chemical_list: D003287:Contrast Media