Open AccessWeekly multimodal MRI follow‐up of two multiple sclerosis active lesions presenting a transient decrease in ADC
Author(s) -
Hannoun Salem,
Roch JeanAmédée,
DurandDubief Francoise,
Vukusic Sandra,
SappeyMarinier Dominique,
Guttmann Charles R.G.,
Cotton Francois
Publication year - 2015
Publication title -
brain and behavior
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.915
H-Index - 41
ISSN - 2162-3279
DOI - 10.1002/brb3.307
Subject(s) - multiple sclerosis , medicine , fluid attenuated inversion recovery , diffusion mri , effective diffusion coefficient , perfusion , nuclear medicine , lesion , concomitant , magnetic resonance imaging , pathology , white matter , radiology , psychiatry
Background and purpose Blood‐brain barrier disruption during the earliest phases of lesion formation in multiple sclerosis ( MS ) patients is commonly ascribed to perivenular inflammatory activity and is usually accompanied by increased diffusivity. Reduced diffusivity has also been shown in active lesions, albeit less frequently. This study aimed to characterize the development and natural history of contrast‐enhanced lesions by weekly following five relapsing remitting ( RR ) MS patients. Materials and methods Diffusion tensor imaging ( DTI ), perfusion imaging, FLAIR and contrast‐enhanced 3D T1‐weighted MR , were weekly performed on five untreated patients recently diagnosed with RR MS . Results All five patients showed significant increases of the apparent diffusion coefficient ( ADC ) in the lesions compared to the first time point. One of the five patients presented 98 active lesions on ADC maps among which 36 had a volume larger than 10 mm 3 . In two of these lesions, a 1 week transient decrease in ADC was detected at the time of the first gadolinium enhancement. Also, the perfusion analysis showed a concomitant increase in the relative cerebral blood volume. Conclusions The infrequency detection of such ADC decrease in a new lesion is probably due to its very short duration. This observation may be consistent with a hyper‐acute inflammatory stage concomitant with an increased reactional perfusion.