title: Ultra-high field MTR and qR2* differentiates subpial cortical lesions from normal-appearing gray matter in multiple sclerosis.
abstract: Cortical gray matter (GM) demyelination is frequent and clinically relevant in multiple sclerosis (MS). Quantitative magnetic resonance imaging (qMRI) sequences such as magnetization transfer ratio (MTR) and quantitative R2* (qR2*) can capture pathological subtleties missed by conventional magnetic resonance imaging (MRI) sequences. Although differences in MTR and qR2* have been reported between lesional and non-lesional tissue, differences between lesion types or lesion types and myelin density matched normal-appearing gray matter (NAGM) have not been found or investigated.
  
  
  
  Identify quantitative differences in histopathologically verified GM lesion types and matched NAGM at ultra-high field strength.
  
  
  
  Using 7T post-mortem MRI, MRI lesions were marked on T2 images and co-registered to the calculated MTR and qR2* maps for further evaluation. In all, 15 brain slices were collected, containing a total of 74 cortical GM lesions and 45 areas of NAGM.
  
  
  
  Intracortical lesions had lower MTR and qR2* values compared to NAGM. Type I lesions showed lower MTR than type III lesions. Type III lesions showed lower MTR than matched NAGM, and type I and IV lesions showed lower qR2* than matched NAGM.
  
  
  
  qMRI at 7T can provide additional information on extent of cortical pathology, especially concerning subpial lesions. This may be relevant for monitoring disease progression and potential treatment effects.
authors.affiliation: Department of Anatomy & Neurosciences, VU University Medical Center, Amsterdam, The Netherlands le.jonkman@vumc.nl.
authors.forename: Laura E
authors.initials: LE
authors.lastname: Jonkman
authors.affiliation: Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Lazar
authors.initials: L
authors.lastname: Fleysher
authors.affiliation: Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands/Department of Physics and Medical Technology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Martijn D
authors.initials: MD
authors.lastname: Steenwijk
authors.affiliation: Department of Anatomy & Neurosciences, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Jan A
authors.initials: JA
authors.lastname: Koeleman
authors.affiliation: Department of Anatomy & Neurosciences, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Teun-Pieter
authors.initials: TP
authors.lastname: de Snoo
authors.affiliation: Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Frederik
authors.initials: F
authors.lastname: Barkhof
authors.affiliation: Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA/Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA/Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy.
authors.forename: Matilde
authors.initials: M
authors.lastname: Inglese
authors.affiliation: Department of Anatomy & Neurosciences, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Jeroen Jg
authors.initials: JJ
authors.lastname: Geurts
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D002540:Cerebral Cortex / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D066128:Gray Matter / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000000981:diagnostic imaging* / Q000473:pathology
keywords: 7T MRI; MTR; cortical lesions; histopathology; multiple sclerosis; qR2*