title: Can MS lesion stages be distinguished with MRI? A postmortem MRI and histopathology study.
abstract: In multiple sclerosis (MS), a histopathological distinction is made between different stages of white matter (WM) lesions. These lesions are characterized as preactive, active, chronic active or chronic inactive, depending on the degree of microglia activation and degree of demyelination. The different lesions are not distinguishable on conventional magnetic resonance imaging (MRI) scans at standard clinical field strengths, but might be distinguished using more advanced, quantitative MRI methods, such as T1 relaxation time (T1-RT) mapping. To investigate this, postmortem brain material from 20 MS patients was investigated, using both T1-RT MRI at 1.5 T and histopathology. The brain material contained a total of 9 preactive, 18 active, 30 chronic active and 14 chronic inactive lesions, as well as 38 areas of normal appearing WM (NAWM). Our results show that, at 1.5 T, T1-RT qMRI can only distinguish between categories NAWM/preactive, active and chronic WM lesions. Advanced imaging at standard field strengths, such as conventional imaging measures, is therefore insufficient to differentiate the WM lesions in MS, and higher field strengths may be required to achieve better pathological differentiation of these lesions.
authors.affiliation: Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, The Netherlands, le.jonkman@vumc.nl.
authors.forename: Laura E
authors.initials: LE
authors.lastname: Jonkman
authors.forename: Alexandra Lopez
authors.initials: AL
authors.lastname: Soriano
authors.forename: Sandra
authors.initials: S
authors.lastname: Amor
authors.forename: Frederik
authors.initials: F
authors.lastname: Barkhof
authors.forename: Paul
authors.initials: P
authors.lastname: van der Valk
authors.forename: Hugo
authors.initials: H
authors.lastname: Vrenken
authors.forename: Jeroen J G
authors.initials: JJ
authors.lastname: Geurts
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000473:pathology*; D066127:White Matter / Q000473:pathology*