7 Tesla MRI of Balo's concentric sclerosis versus multiple sclerosis lesions

Background: Baló's concentric sclerosis (BCS) is a rare condition characterized by concentrically layered white matter lesions. While its pathogenesis is unknown, hypoxia-induced tissue injury and chemotactic stimuli have been proposed as potential causes of BCS lesion formation. BCS has been...

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Hauptverfasser: Behrens, Janina R. (VerfasserIn) , Jarius, Sven (VerfasserIn) , Wildemann, Brigitte (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 29 June 2018
In: Annals of Clinical and Translational Neurology
Year: 2018, Jahrgang: 5, Heft: 8, Pages: 900-912
ISSN:2328-9503
DOI:10.1002/acn3.572
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1002/acn3.572
Verlag, lizenzpflichtig, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1002/acn3.572
Volltext
Verfasserangaben:Janina R. Behrens, Julia Wanner, Joseph Kuchling, Lennard Ostendorf, Lutz Harms, Klemens Ruprecht, Thoralf Niendorf, Sven Jarius, Brigitte Wildemann, René M. Gieß, Michael Scheel, Judith Bellmann‐Strobl, Jens Wuerfel, Friedemann Paul & Tim Sinnecker

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520 |a Background: Baló's concentric sclerosis (BCS) is a rare condition characterized by concentrically layered white matter lesions. While its pathogenesis is unknown, hypoxia-induced tissue injury and chemotactic stimuli have been proposed as potential causes of BCS lesion formation. BCS has been suggested to be a variant of multiple sclerosis (MS). Here, we aimed to elucidate similarities and differences between BCS and MS by describing lesion morphology and localization in high-resolution 7 Tesla (7 T) magnetic resonance imaging (MRI) scans. Methods: Ten patients with Baló-type lesions underwent 7 T MRI, and 10 relapsing remitting MS patients served as controls. The 7 T MR imaging protocol included 3D T1-weighted (T1w) magnetization-prepared rapid gradient echo, 2D high spatial resolution T2*-weighted (T2*w) fast low-angle shot and susceptibility-weighted imaging. Results: Intralesional veins were visible in the center of all but one Baló-type lesion. Four Baló-type lesions displayed inhomogeneous intralesional T2*w signal intensities, which are suggestive of microhemorrhages or small ectatic venules. Eight of 10 BCS patients presented with 97 additional lesions, 36 of which (37%) had a central vein. Lesions involving the cortical gray matter and the U-fibers were not detected in BCS patients. Conclusion: Our findings support the hypothesis that BCS and MS share common pathogenetic mechanisms but patients present with different lesion phenotypes. 
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