title: Heterogeneity of acute multiple sclerosis lesions on sodium (23Na) MRI.
abstract: Advanced magnetic resonance imaging (MRI) techniques provide a window into pathological processes in multiple sclerosis (MS). Nevertheless, to date only few studies have performed sodium MRI in MS.
  
  
  
  We analysed total sodium concentration (TSC) in hyperacute, acute and chronic lesions in MS with (23)Na MRI.
  
  
  
  (23)Na MRI and (1)H MRI were performed in 65 MS patients and 10 healthy controls (HC). Mean TSC was quantified in all MS lesions with a diameter of >5 mm and in the normal appearing white and grey matter (NAWM, NAGM).
  
  
  
  TSC in the NAWM and the NAGM of MS patients was significantly higher compared to HC (WM: 37.51 ± 2.65 mM versus 35.17 ± 3.40 mM; GM: 43.64 ± 2.75 mM versus 40.09 ± 4.64 mM). Acute and chronic MS lesions showed elevated TSC levels of different extent (contrast-enhancing lesions (49.07 ± 6.99 mM), T1 hypointense lesions (45.06 ± 6.26 mM) and remaining T1 isointense lesions (39.88 ± 5.54 mM)). However, non-enhancing hyperacute lesions with a reduced apparent diffusion coefficient showed a TSC comparable to the NAWM (37.22 ± 4.62 mM).
  
  
  
  TSC is not only a sensitive marker of the severity of chronic tissue abnormalities in MS but is also highly sensitive to opening of the blood-brain barrier and vasogenic tissue oedema in contrast-enhancing lesions.
authors.affiliation: Department of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Eisele
authors.affiliation: MR-Imaging and Spectroscopy, Faculty 01 (Physics/Electrical Engineering), University of Bremen, Germany/ Computer Assisted Clinical Medicine, Universitätsmedizin Mannheim, University of Heidelberg, Germany.
authors.forename: Simon
authors.initials: S
authors.lastname: Konstandin
authors.affiliation: Department of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Griebe
authors.affiliation: Department of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Germany.
authors.forename: Kristina
authors.initials: K
authors.lastname: Szabo
authors.affiliation: Department of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Germany.
authors.forename: Marc E
authors.initials: ME
authors.lastname: Wolf
authors.affiliation: Department of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Germany.
authors.forename: Angelika
authors.initials: A
authors.lastname: Alonso
authors.affiliation: Department of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Germany.
authors.forename: Anne
authors.initials: A
authors.lastname: Ebert
authors.affiliation: Department of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Serwane
authors.affiliation: Department of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Germany.
authors.forename: Christina
authors.initials: C
authors.lastname: Rossmanith
authors.affiliation: Department of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Germany.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Hennerici
authors.affiliation: Computer Assisted Clinical Medicine, Universitätsmedizin Mannheim, University of Heidelberg, Germany.
authors.forename: Lothar R
authors.initials: LR
authors.lastname: Schad
authors.affiliation: Department of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Germany achim.gass@medma.uni-heidelberg.de.
authors.forename: Achim
authors.initials: A
authors.lastname: Gass
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D003287:Contrast Media / Q000008:administration & dosage; D003430:Cross-Sectional Studies; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D066128:Gray Matter / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D011237:Predictive Value of Tests; D012975:Sodium Isotopes / Q000008:administration & dosage / Q000378:metabolism*; D066127:White Matter / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D055815:Young Adult
chemical_list: D003287:Contrast Media; D012975:Sodium Isotopes
keywords: Multiple sclerosis; diffusion; magnetic resonance imaging; sodium