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Advances in Imaging of Multiple Sclerosis, An Issue of Neuroimaging Clinics of North America, E-Book

Advances in Imaging of Multiple Sclerosis, An Issue of Neuroimaging Clinics of North America, E-Book

Alex Rovira

(2017)

Additional Information

Abstract

This issue of Neuroimaging Clinics of North America focuses on Imaging of Multiple Sclerosis: Diagnosis and Management, and is edited by Dr. Àlex Rovira Cañellas. Articles will include: Multiple Sclerosis: Epidemiological, Clinical and Therapeutic Aspects; Brain and Spinal Cord MR Imaging Features in Multiple Sclerosis and Variants; Neuromyelitis Optica Spectrum Disorders; Radiologically Isolated Syndrome; MRI in Monitoring and Predicting Treatment Response in Multiple Sclerosis; Cortical Grey Matter MR Imaging in Multiple Sclerosis; Brain Atrophy in Multiple Sclerosis: Technical Aspects and Clinical Relevance; Iron Mapping in Multiple Sclerosis; Microstructural MR Techniques in Multiple Sclerosis; Molecular and Metabolic Imaging in Multiple Sclerosis; Insights from Ultra-high Field Imaging in Multiple Sclerosis; Pediatric Multiple Sclerosis: Distinguishing Clinical and MRI Features, and more!

Table of Contents

Section Title Page Action Price
Front Cover Cover
Advances in Imaging of Multiple Sclerosis\r i
Copyright\r ii
CME Accreditation Page iii
PROGRAM OBJECTIVE iii
TARGET AUDIENCE iii
LEARNING OBJECTIVES iii
ACCREDITATION iii
DISCLOSURE OF CONFLICTS OF INTEREST iii
UNAPPROVED/OFF-LABEL USE DISCLOSURE iv
TO ENROLL iv
METHOD OF PARTICIPATION iv
CME INQUIRIES/SPECIAL NEEDS iv
Contributors vii
CONSULTING EDITOR vii
EDITOR vii
AUTHORS vii
Contents xi
Foreword: Imaging in Multiple Sclerosis: Diagnosis and Management xi
Preface: Advances in the Diagnosis, Characterization, and Monitoring of Multiple Sclerosis xi
Multiple Sclerosis: Epidemiologic, Clinical, and Therapeutic Aspects xi
Brain and Spinal Cord MR Imaging Features in Multiple Sclerosis and Variants xi
Pediatric Multiple Sclerosis: Distinguishing Clinical and MR Imaging Features xi
Neuromyelitis Optica Spectrum Disorders xi
Radiologically Isolated Syndrome: MR Imaging Features Suggestive of Multiple Sclerosis Prior to First Symptom Onset xii
MR Imaging in Monitoring and Predicting Treatment Response in Multiple Sclerosis xii
Brain Atrophy in Multiple Sclerosis: Clinical Relevance and Technical Aspects xii
Cortical Gray Matter MR Imaging in Multiple Sclerosis xii
Microstructural MR Imaging Techniques in Multiple Sclerosis xiii
Iron Mapping in Multiple Sclerosis xiii
Molecular and Metabolic Imaging in Multiple Sclerosis xiii
Insights from Ultrahigh Field Imaging in Multiple Sclerosis xiii
Imaging in Multiple Sclerosis: Diagnosis and Management xv
Advances in the Diagnosis, Characterization, and Monitoring of Multiple Sclerosis xvii
Multiple Sclerosis 195
Key points 195
INTRODUCTION AND EPIDEMIOLOGY 195
CLINICAL MANIFESTATION AND NATURAL COURSE 195
DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS 197
TREATMENT 198
Injectable Therapies 198
Interferon beta 198
Brain and Spinal Cord MR Imaging Features in Multiple Sclerosis and Variants 205
Key points 205
INTRODUCTION 205
IMAGING OF MULTIPLE SCLEROSIS, MR IMAGING PROTOCOLS OF BRAIN, SPINAL CORD, AND TREATMENT MONITORING 206
MR Imaging Protocol of the Brain 206
MR Imaging Protocol of the Spinal Cord 207
MR Imaging Protocol of the Optic Nerve 208
MR Imaging Protocol for Treatment Monitoring 208
MULTIPLE SCLEROSIS PATHOLOGY IN THE BRAIN AND SPINAL CORD 209
Imaging Brain Pathology 209
White matter pathology: focal lesions 209
White matter pathology: diffuse abnormalities 211
Gray matter pathology: cortical lesions 211
Gray matter pathology: brain atrophy 212
Imaging Spinal Cord Pathology 212
Focal lesions 212
Diffuse abnormalities 212
Atrophy 212
DIAGNOSTIC CRITERIA 214
Radiologically Isolated Syndrome 214
Clinically Isolated Syndrome and Relapsing-Remitting Multiple Sclerosis 214
Progressive Disease Courses 215
MULTIPLE SCLEROSIS VARIANTS AND DIFFERENTIAL DIAGNOSIS 215
Multiple Sclerosis Variants 215
Tumefactive multiple sclerosis, acute multiple sclerosis (Marburg disease), and Balo concentric sclerosis 221
Tumefactive multiple sclerosis 221
Differential Diagnosis 221
SUMMARY 222
REFERENCES 223
Pediatric Multiple Sclerosis 229
Key points 229
INTRODUCTION 229
DIAGNOSTIC CRITERIA OF PEDIATRIC MULTIPLE SCLEROSIS 229
DISTINGUISHING CLINICAL FEATURES 231
DISTINGUISHING MR IMAGING FEATURES 232
Conventional MR imaging 232
Advanced Imaging Techniques 235
Brain Volumetry 235
Magnetization Transfer Imaging 236
Cortical Imaging Techniques 237
Diffusion Tensor Imaging 237
Proton MR Spectroscopy 238
Susceptibility-Weighted Imaging to Differentiate Acute Disseminated Encephalomyelitis from Multiple Sclerosis 239
DIFFERENTIAL DIAGNOSIS 239
Acute Disseminated Encephalomyelitis 239
Neuromyelitis Optica Spectrum Disorder 244
Susac Syndrome 244
SUMMARY 247
REFERENCES 247
Neuromyelitis Optica Spectrum Disorders 251
Key points 251
INTRODUCTION 251
ANTI-AQUAPORIN-4-AUTOANTIBODY-SEROPOSITIVE NEUROMYELITIS OPTICA SPECTRUM DISORDER 252
MR Imaging Findings 252
Optic neuritis 252
Distribution 252
Characteristics in the acute phase 252
Characteristics in the chronic phase 252
Acute myelitis 254
Longitudinally extensive transverse myelitis 254
Axial view of longitudinally extensive transverse myelitis 254
Spinal cord atrophy in the chronic phase 254
Area postrema lesions and other brainstem lesions 254
Diencephalic lesions 255
Cerebral lesions 255
Advanced MR Imaging in Patients With Anti-aquaporin-4-Autoantibody 255
Optical Coherence Tomography Findings in Chronic Phase (﹥3 Months from Onset) 256
Circumpapillary retinal nerve fiber layer 256
Macular ganglion cell complex 256
ANTI-MYELIN OLIGODENDROCYTE GLYCOPROTEIN-AUTOANTIBODY–SEROPOSITIVE NEUROMYELITIS OPTICA SPECTRUM DISORDER 257
MR Imaging Findings 259
Optic nerve lesions 259
Distribution 259
Optic neuritis lesions in the acute phase 260
Optic neuritis lesions in the chronic phase 260
Spinal cord lesions 260
Cerebral lesions 260
Brainstem lesions 261
Optical Coherence Tomography Findings in Chronic Phase 263
Circumpapillary retinal nerve fiber layer 263
Macular ganglion cell complex 263
SUMMARY 264
DISCLOSURE STATEMENTS 264
REFERENCES 265
Radiologically Isolated Syndrome 267
Key points 267
INTRODUCTION 267
THE CONCEPT OF PRECLINICAL DISEASE ACTIVITY 268
RADIOLOGICALLY ISOLATED SYNDROME 269
RADIOLOGICALLY ISOLATED SYNDROME EVOLVING TO PRIMARY PROGRESSIVE MULTIPLE SCLEROSIS 270
COGNITIVE FUNCTION IN RADIOLOGICALLY ISOLATED SYNDROME 271
THE CLINICAL MANAGEMENT OF RADIOLOGICALLY ISOLATED SYNDROME SUBJECTS 272
RISK OF INACCURATE CLASSIFICATION 272
SUMMARY 273
REFERENCES 274
MR Imaging in Monitoring and Predicting Treatment Response in Multiple Sclerosis 277
Key points 277
INTRODUCTION 277
MR IMAGING MEASURES 278
Conventional Techniques 278
Brain Atrophy 278
PROGNOSTIC VALUE OF BASELINE MR IMAGING 280
EVALUATION OF TREATMENT RESPONSE 281
Early Prediction 281
Monitoring Treatment Response 282
Scoring Systems 284
Advantages and Limitations of Scoring Systems 285
RECOMMENDATIONS 285
FUTURE PROSPECTS 285
REFERENCES 285
Brain Atrophy in Multiple Sclerosis 289
Key points 289
INTRODUCTION 289
BRAIN ATROPHY IN MULTIPLE SCLEROSIS: A PATHOLOGIC PROCESS 290
NATURAL HISTORY OF BRAIN ATROPHY IN MULTIPLE SCLEROSIS 290
CLINICAL RELEVANCE OF BRAIN ATROPHY IN MULTIPLE SCLEROSIS: CONCURRENT AND PREDICTIVE VALUE 290
BRAIN ATROPHY MEASURES AS A TREATMENT MONITORING TOOL 291
BRAIN VOLUME MEASUREMENTS 292
Technical Aspects 292
CONFOUNDING FACTORS RELATED TO IMAGE ACQUISITION 293
Head Motion During Image Acquisition 293
Magnet System Upgrade 293
Acquisition Protocols 294
Gradient Distortion 294
Scan-Rescan Variability 294
CONFOUNDING FACTORS RELATED TO MEASUREMENT METHODS 295
Brain Volume Measures 295
Deep Gray Matter Regions 295
Brain Volume Longitudinal Changes 295
Voxel-Based Morphometry 295
Cortical Thickness 295
NON–MULTIPLE SCLEROSIS–RELATED BIOLOGICAL CONFOUNDING FACTORS 295
Age 295
Gender and Brain Size 296
Diurnal Fluctuations 296
Hydration State 296
Cardiovascular Risk Factors 296
Genetic and Environmental Confounding Factors 296
MULTIPLE SCLEROSIS–RELATED BIOLOGICAL CONFOUNDING FACTORS 296
White Matter Focal Lesions 296
Pseudoatrophy Effect 296
SUMMARY 297
REFERENCES 297
Cortical Gray Matter MR Imaging in Multiple Sclerosis 301
Key points 301
INTRODUCTION 301
FOCAL GRAY MATTER ABNORMALITY 301
The Cortical Lesions 301
Imaging Cortical Lesions by MR Imaging 302
THE DIFFUSE GRAY MATTER DAMAGE 303
The Normal-Appearing Gray Matter 303
Imaging the Normal-Appearing Gray Matter 304
Global and regional analysis of cortical atrophy 304
Proton magnetic resonance spectroscopy 306
Magnetization transfer MR imaging 306
Diffusion-weighted MR imaging 307
Susceptibility-weighted imaging 308
Perfusion imaging 309
SUMMARY 309
REFERENCES 309
Microstructural MR Imaging Techniques in Multiple Sclerosis 313
Key points 313
INTRODUCTION 313
METHODOLOGICAL CONSIDERATIONS 314
MAGNETIZATION TRANSFER MR IMAGING 314
Background 314
Lesions 314
Normal-Appearing Brain Tissues, White Matter, and Gray Matter 317
Clinical Correlates 317
Spinal Cord 318
Optic Nerve 319
Monitoring Multiple Sclerosis Treatment 319
Future Perspectives 319
DIFFUSION MR IMAGING 319
Background 319
Lesions 321
Normal-Appearing Brain Tissue, White Matter, and Gray Matter 322
Clinical Correlates 324
Spinal Cord 325
Optic Nerve 325
Monitoring Multiple Sclerosis Treatment 326
Future Perspectives 326
SUMMARY 326
REFERENCES 327
Iron Mapping in Multiple Sclerosis 335
Key points 335
INTRODUCTION 335
IRON DISTRIBUTION AND METABOLISM IN THE NORMAL BRAIN 335
ALTERED IRON HOMEOSTASIS IN THE BRAIN WITH MULTIPLE SCLEROSIS 336
MAGNETIC PROPERTIES OF IRON COMPOUNDS 336
IRON MAPPING IN THE HUMAN BRAIN WITH MR IMAGING 337
IRON MAPPING USING MR IMAGING OF THE BRAIN IN MULTIPLE SCLEROSIS: INSIGHTS, LIMITATIONS, AND PROSPECTS 339
SUMMARY 340
REFERENCES 340
Molecular and Metabolic Imaging in Multiple Sclerosis 343
Key points 343
INTRODUCTION 343
MAGNETIC RESONANCE SPECTROSCOPY 345
N-Acetyl-Aspartate 345
Glutamate and Glutamine 347
γ-Aminobutyric Acid 347
Creatine 348
Choline-Containing Compounds 348
Myo-Inositol 348
Limitations 349
SODIUM IMAGING 349
PET 350
Inflammatory Markers 350
Translocator protein PET 350
18F-FDG PET 351
Purine PET 351
Myelin Markers 352
Amyloid PET 352
Neuronal Markers 352
11C-flumazenil PET 352
Markers of Astrocyte Activation 352
11C-acetate PET 352
Choline PET 353
Limitations 353
SUMMARY 353
REFERENCES 353
Insights from Ultrahigh Field Imaging in Multiple Sclerosis 357
Key points 357
INTRODUCTION 357
LESION DETECTION AND CHARACTERIZATION 358
White Matter 358
Gray Matter 358
CENTRAL VEINS 360
ACUTE LESION EVOLUTION 361
LESION OUTCOMES 362
Qualitative Imaging 362
Quantitative Imaging 363
SPINAL CORD 364
LIMITATIONS AND CHALLENGES 364
FUTURE DIRECTIONS 364
ACKNOWLEDGMENTS 364
REFERENCES 364
Index 367