Purpose

In multiple sclerosis (MS), chronic active/smoldering white matter lesions presenting with hypointense rims on susceptibility-weighted imaging (SWI) of the brain have been recognized as an important radiological feature. The aim of this work was to study the prevalence of paramagnetic rim lesions (RLs) in MS patients in a clinical setting and to assess differences in demographic and clinical variables regarding the presence of RLs.

Methods

All 3 T brain magnetic resonance (MR) studies performed in MS patients between July 2020 and January 2021 were reviewed. In all patients, RLs were assessed on three-dimensional (3D) SWI images and the T2 FLAIR lesion load volume was assessed. Demographic, laboratory (oligoclonal bands in CSF), and clinical data, including functional status with Expanded Disability Status Scale (EDSS), were retrieved from the clinical files.

Results

Of the 192 patients, 113 (59%) presented with at least 1 RL. In the RL-positive group, the mean RL count was 4.81 ranging from 1 to 37. There was no significant difference in the number of RLs between the different types of MS (p = 0.858). Regarding the presence of RLs, there were no significant differences based on gender (p = 0.083), disease duration (p = 0.520), treatment regime (p = 0.326), EDSS score (p = 0.103), and the associated T2 FLAIR lesion load volume.

Conclusion

SWI RLs were frequently detected in our cohort regardless of the MS type, T2 FLAIR lesion load volume, demographic features, disease duration, or clinical score. Our results suggest that RLs are not associated with more severe forms of the disease. Today, RLs can be seen on 3 T 3D SWI, although this is not a clinical standard sequence yet. Therefore, it should be considered an additional helpful MR sequence in the diagnostic workup of MS, although more studies are warranted to establish the role of RLs as prognostic markers.

中文翻译：

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MS中的阴燃病变：如果你喜欢它，那么你应该在它上面放一个边缘

目的

在多发性硬化症 (MS) 中，慢性活动性/冒烟性白质病变在大脑的磁敏感加权成像 (SWI) 上呈现低信号边缘，已被认为是重要的放射学特征。这项工作的目的是研究临床环境中 MS 患者顺磁性边缘病变 (RLs) 的患病率，并评估关于 RLs 存在的人口统计学和临床​​变量的差异。

方法

回顾了 2020 年 7 月至 2021 年 1 月期间在 MS 患者中进行的所有 3 T 脑磁共振 (MR) 研究。在所有患者中，RLs 均在三维 (3D) SWI 图像上进行评估，并评估 T2 FLAIR 病灶负荷量。从临床文件中检索人口统计学、实验室（CSF 中的寡克隆带）和临床数据，包括扩展残疾状态量表 (EDSS) 的功能状态。

结果

在 192 名患者中，113 名 (59%) 出现至少 1 次 RL。在 RL 阳性组中，平均 RL 计数为 4.81，范围从 1 到 37。不同类型 MS 之间的 RL 数量没有显着差异（p  = 0.858）。关于 RLs 的存在，在性别 ( p  = 0.083)、疾病持续时间 ( p  = 0.520)、治疗方案 ( p  = 0.326)、EDSS 评分 ( p  = 0.103) 和相关的 T2 FLAIR 病变方面没有显着差异负载量。

结论

无论 MS 类型、T2 FLAIR 病变负荷量、人口统计学特征、疾病持续时间或临床评分如何，我们的队列中经常检测到 SWI RL。我们的结果表明，RLs 与更严重的疾病形式无关。今天，可以在 3 T 3D SWI 上看到 RL，尽管这还不是临床标准序列。因此，尽管需要更多的研究来确定 RLs 作为预后标志物的作用，但它应该被认为是 MS 诊断检查中额外有用的 MR 序列。