Wayne State University
Department of Radiology

Author Of 1 Presentation

Imaging Poster Presentation

P0537 - Analysis of Vascular abnormalities for lesions in MS using USPIO (ID 781)

Speakers
Presentation Number
P0537
Presentation Topic
Imaging

Abstract

Background

Multiple Sclerosis (MS) is a progressive, inflammatory and neurodegenerative disease of the CNS, characterized by a wide range of symptoms, autoimmune responses, and vascular dysfunction. Ultra-small superparamagnetic iron oxides (USPIO) agent, Ferumoxytol, was administered to induce an increase in susceptibility in both arterial and venous blood; which helped in revealing the cerebral microvasculature.

Objectives

To reveal and examine the vascular anomalies in MS patients using Ferumoxytol and high-resolution susceptibility weighted imaging (SWI).

Methods

Six subjects with relapsing remitting MS were included in the study (47.33 ± 11.75 years with 3 females and 3 males) and were scanned with a 3T MRI scanner (Ferumoxytol dose = 4 mg/kg). All patients were scanned with a dual-echo optimized gradient echo sequence (TE1/TE2/TR = 7.5ms/15ms/27ms) with an in-plane resolution of 0.22×0.44 mm2 interpolated to 0.22×0.22 mm2 and a slice thickness of 1 mm (3 subjects) and 1.5 mm (3 subjects). 3D FLAIR data was also acquired with: TR/TE/TI = 6000ms/405ms/2000ms and a resolution of 0.88×0.88×2mm3. Composite SWI-FLAIR data was generated by registering the FLAIR data to the high resolution SWI data and then multiplying the phase mask onto the registered FLAIR data to highlight the vascular information on the white matter hyperintensities (WMH). The lesions with anomalous vascular behavior such as engorged and shortened vessels within WMHs, small WMHs appearing only at the vessel boundary and developmental venous angiomas were identified for each subject. For the remaining WMHs, the central vessel sign (CVS) and, due to the presence of several underlying vessels, multiple vessel sign (MVS) were identified on pre- and post-contrast SWI-FLAIR data.

Results

A total of 489 lesions were identified across all patients. The total number of CVS and MVS on pre-contrast data were 142 and 12, respectively; whereas the total number of CVS and MVS on post-contrast data were 308 and 81, respectively. This shows a significant increase in visibility of the vasculature after Ferumoxytol administration. Additionally, the vessel anomalies observed within WMHs increased from 11 on pre-contrast to 72 on post-contrast data.

Conclusions

By inducing a non-zero susceptibility into the blood using Ferumoxytol, both small arteries and veins at the sub-voxel level of 50-100 µm were revealed, which was only possible previously in cadaver brain studies. This approach has the potential to monitor the venous vasculature present in MS lesions, catalogue their characteristics and compare the vascular structures spatially to the presence of WMH, which may provide new insight into the pathophysiology of MS.

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