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| Item Type: | Article |
|---|---|
| Title: | Paramagnetic rims are a promising diagnostic imaging biomarker in multiple sclerosis |
| Creators Name: | Meaton, I., Altokhis, A., Allen, C.M., Clarke, M.A., Sinnecker, T., Meier, D., Enzinger, C., Calabrese, M., De Stefano, N., Pitiot, A., Giorgio, A., Schoonheim, M.M., Paul, F., Pawlak, M.A., Schmidt, R., Granziera, C., Kappos, L., Montalban, X., Rovira, À., Wuerfel, Jens and Evangelou, N. |
| Abstract: | BACKGROUND: White matter lesions (WMLs) on brain magnetic resonance imaging (MRI) in multiple sclerosis (MS) may contribute to misdiagnosis. In chronic active lesions, peripheral iron-laden macrophages appear as paramagnetic rim lesions (PRLs). OBJECTIVE: To evaluate the sensitivity and specificity of PRLs in differentiating MS from mimics using clinical 3T MRI scanners. METHOD: This retrospective international study reviewed MRI scans of patients with MS (n = 254), MS mimics (n = 91) and older healthy controls (n = 217). WMLs, detected using fluid-attenuated inversion recovery MRI, were analysed with phase-sensitive imaging. Sensitivity and specificity were assessed for PRLs. RESULTS: At least one PRL was found in 22.9% of MS and 26.1% of clinically isolated syndrome (CIS) patients. Only one PRL was found elsewhere. The identification of ?1 PRL was the optimal cut-off and had high specificity (99.7%, confidence interval (CI) = 98.20%-99.99%) when distinguishing MS and CIS from mimics and healthy controls, but lower sensitivity (24.0%, CI = 18.9%-36.6%). All patients with a PRL showing a central vein sign (CVS) in the same lesion (n = 54) had MS or CIS, giving a specificity of 100% (CI = 98.8%-100.0%) but equally low sensitivity (21.3%, CI = 16.4%-26.81%). CONCLUSION: PRLs may reduce diagnostic uncertainty in MS by being a highly specific imaging diagnostic biomarker, especially when used in conjunction with the CVS. |
| Keywords: | Multiple Sclerosis, MRI, CIS, Biomarkers |
| Source: | Multiple Sclerosis Journal |
| ISSN: | 1352-4585 |
| Publisher: | Sage Publications |
| Volume: | 28 |
| Number: | 14 |
| Page Range: | 2212-2220 |
| Date: | December 2022 |
| Official Publication: | https://doi.org/10.1177/13524585221118677 |
| PubMed: | View item in PubMed |
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