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Contrast-enhanced fat-suppressed FLAIR for the characterization of leptomeningeal inflammation in optic neuritis

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BACKGROUND: Leptomeningeal contrast enhancement on fluid-attenuated inversion recovery (FLAIR) images has been reported in patients with multiple sclerosis and interpreted as a biomarker of inflammation. In this study, we sought to evaluate this phenomenon in patients with optic neuritis (ON). - MET...

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Main Authors: Pino-Lopez, Luis (Author) , Wenz, Holger (Author) , Böhme, Johannes (Author) , Maros, Máté E. (Author) , Schlichtenbrede, Frank (Author) , Groden, Christoph (Author) , Förster, Alex (Author)
Format: Article (Journal)
Language:English
Published: 2019
In: Multiple sclerosis journal
Year: 2018, Volume: 25, Issue: 6, Pages: 792-800
ISSN:1477-0970
DOI:10.1177/1352458518770268
Online Access:Verlag, Volltext: http://dx.doi.org/10.1177/1352458518770268
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Author Notes:Luis Pino-Lopez, Holger Wenz, Johannes Böhme, Máté Maros, Frank Schlichtenbrede, Christoph Groden and Alex Förster
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Summary:BACKGROUND: Leptomeningeal contrast enhancement on fluid-attenuated inversion recovery (FLAIR) images has been reported in patients with multiple sclerosis and interpreted as a biomarker of inflammation. In this study, we sought to evaluate this phenomenon in patients with optic neuritis (ON). - METHODS: A total of 42 patients with suspected ON were included in this prospective study and underwent a dedicated study magnetic resonance imaging (MRI) protocol including native and contrast-enhanced fat-suppressed thin-section axial and coronal FLAIR images on an 1.5 T magnetic resonance (MR) system. - RESULTS: After diagnostic workup, 34 patients with final diagnosis of ON were analyzed in detail. On contrast-enhanced fat-suppressed FLAIR images, 25 (73.5%) patients with ON demonstrated perioptic leptomeningeal enhancement, and in 3 (8.8%) patients, this was even the only pathological MRI finding. In comparison, patients with perioptic leptomeningeal enhancement on contrast-enhanced fat-suppressed FLAIR images had a higher prevalence of additional hyperintense brain lesions ( p = 0.022) as well as cerebrospinal fluid (CSF)-specific oligoclonal bands ( p = 0.013) than patients without. - CONCLUSION: Perioptic leptomeningeal contrast enhancement on fat-suppressed FLAIR images is a novel marker in ON and possibly reflects a leptomeningeal inflammatory process preceding or accompanying ON. Thin-section contrast-enhanced fat-suppressed FLAIR images might be a useful addition in MRI protocols for patients with suspected ON.
Item Description:First Published: April 23, 2018
Gesehen am 28.05.2019
Physical Description:Online Resource
ISSN:1477-0970
DOI:10.1177/1352458518770268

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