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SWI enhances vein detection using gadolinium in multiple sclerosis.

Maggi P, Mazzoni LN, Moretti M, Grammatico M, Chiti S, Massacesi L - Acta Radiol Open (2015)

Bottom Line: In addition, in MS white matter (WM) lesions, gadolinium-based contrast media (CM) can increase vein signal loss on SWI.This report focuses on two cases of WM inflammatory lesions enhancing on SWI images after CM injection.In these lesions in fact the CM increased the contrast between the parenchyma and the central vein allowing as well, in one of the two cases, the detection of a vein not visible on the same SWI sequence acquired before CM injection.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosciences, Drug Research, and Child's Health, University of Florence, Florence, Italy.

ABSTRACT
Susceptibility weighted imaging (SWI) combined with the FLAIR sequence provides the ability to depict in vivo the perivenous location of inflammatory demyelinating lesions - one of the most specific pathologic features of multiple sclerosis (MS). In addition, in MS white matter (WM) lesions, gadolinium-based contrast media (CM) can increase vein signal loss on SWI. This report focuses on two cases of WM inflammatory lesions enhancing on SWI images after CM injection. In these lesions in fact the CM increased the contrast between the parenchyma and the central vein allowing as well, in one of the two cases, the detection of a vein not visible on the same SWI sequence acquired before CM injection.

No MeSH data available.


Related in: MedlinePlus

Left peritrigonal focal WM lesion (arrows) appearing hyperintense on (a) the axial pre-CM FLAIR and (b) the axial pre-CM SWI. In addition SWI shows a small faint hypointense area in the lesion center (magnified view) that can be ascribed to the presence of a central vein. (c) The lesion appears visibly contrast-enhancing on the axial post-CM MPRAGE and (d) the axial post-CM SWI. The hypointense vein (already visible on the precontrast SWI) here appears enlarged and the contrast between the small hyperintense contrast-enhancing lesion and its hypointense central vein, appears increased (magnified view).
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fig1-2047981614560938: Left peritrigonal focal WM lesion (arrows) appearing hyperintense on (a) the axial pre-CM FLAIR and (b) the axial pre-CM SWI. In addition SWI shows a small faint hypointense area in the lesion center (magnified view) that can be ascribed to the presence of a central vein. (c) The lesion appears visibly contrast-enhancing on the axial post-CM MPRAGE and (d) the axial post-CM SWI. The hypointense vein (already visible on the precontrast SWI) here appears enlarged and the contrast between the small hyperintense contrast-enhancing lesion and its hypointense central vein, appears increased (magnified view).

Mentions: A 52-year-old woman with a 7-year history of relapsing focal neurological deficits was admitted to the Neurological Department in order to establish a diagnosis. The patient had never been treated with immunosuppressive or immunomodulatory drugs. During the diagnostic workout, the patient underwent brain MRI examination on a 1.5T scanner (Magnetom Siemens Aera, Erlangen, Germany). The acquisition protocol included precontrast media injection (pre-CM) fluid attenuated inversion recovery (FLAIR), pre- and postcontrast media injection (post-CM) SWI, and 3D T1W MPRAGE. Post-CM SWI and subsequently the MPRAGE were executed 1 min after contrast administration. On pre-CM FLAIR images, a focal hyperintense WM matter lesion was detected in the left peritrigonal region (Fig. 1). The hyperintense lesion was also visible on the pre-CM SWI that showed in addition a small faint hypointense round shaped area in the center of the lesion attributable to a vein (Fig. 1b). After CM administration the lesion appeared hyperintense, visibly contrast enhancing, not only on the MPRAGE (Fig. 1c) but also on the post-CM SWI while the hypointense central area, previously barely visible on the pre-CM SWI, appeared now enlarged (Fig. 1d).Fig. 1.


SWI enhances vein detection using gadolinium in multiple sclerosis.

Maggi P, Mazzoni LN, Moretti M, Grammatico M, Chiti S, Massacesi L - Acta Radiol Open (2015)

Left peritrigonal focal WM lesion (arrows) appearing hyperintense on (a) the axial pre-CM FLAIR and (b) the axial pre-CM SWI. In addition SWI shows a small faint hypointense area in the lesion center (magnified view) that can be ascribed to the presence of a central vein. (c) The lesion appears visibly contrast-enhancing on the axial post-CM MPRAGE and (d) the axial post-CM SWI. The hypointense vein (already visible on the precontrast SWI) here appears enlarged and the contrast between the small hyperintense contrast-enhancing lesion and its hypointense central vein, appears increased (magnified view).
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License 1 - License 2 - License 3
Show All Figures
getmorefigures.php?uid=PMC4372566&req=5

fig1-2047981614560938: Left peritrigonal focal WM lesion (arrows) appearing hyperintense on (a) the axial pre-CM FLAIR and (b) the axial pre-CM SWI. In addition SWI shows a small faint hypointense area in the lesion center (magnified view) that can be ascribed to the presence of a central vein. (c) The lesion appears visibly contrast-enhancing on the axial post-CM MPRAGE and (d) the axial post-CM SWI. The hypointense vein (already visible on the precontrast SWI) here appears enlarged and the contrast between the small hyperintense contrast-enhancing lesion and its hypointense central vein, appears increased (magnified view).
Mentions: A 52-year-old woman with a 7-year history of relapsing focal neurological deficits was admitted to the Neurological Department in order to establish a diagnosis. The patient had never been treated with immunosuppressive or immunomodulatory drugs. During the diagnostic workout, the patient underwent brain MRI examination on a 1.5T scanner (Magnetom Siemens Aera, Erlangen, Germany). The acquisition protocol included precontrast media injection (pre-CM) fluid attenuated inversion recovery (FLAIR), pre- and postcontrast media injection (post-CM) SWI, and 3D T1W MPRAGE. Post-CM SWI and subsequently the MPRAGE were executed 1 min after contrast administration. On pre-CM FLAIR images, a focal hyperintense WM matter lesion was detected in the left peritrigonal region (Fig. 1). The hyperintense lesion was also visible on the pre-CM SWI that showed in addition a small faint hypointense round shaped area in the center of the lesion attributable to a vein (Fig. 1b). After CM administration the lesion appeared hyperintense, visibly contrast enhancing, not only on the MPRAGE (Fig. 1c) but also on the post-CM SWI while the hypointense central area, previously barely visible on the pre-CM SWI, appeared now enlarged (Fig. 1d).Fig. 1.

Bottom Line: In addition, in MS white matter (WM) lesions, gadolinium-based contrast media (CM) can increase vein signal loss on SWI.This report focuses on two cases of WM inflammatory lesions enhancing on SWI images after CM injection.In these lesions in fact the CM increased the contrast between the parenchyma and the central vein allowing as well, in one of the two cases, the detection of a vein not visible on the same SWI sequence acquired before CM injection.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosciences, Drug Research, and Child's Health, University of Florence, Florence, Italy.

ABSTRACT
Susceptibility weighted imaging (SWI) combined with the FLAIR sequence provides the ability to depict in vivo the perivenous location of inflammatory demyelinating lesions - one of the most specific pathologic features of multiple sclerosis (MS). In addition, in MS white matter (WM) lesions, gadolinium-based contrast media (CM) can increase vein signal loss on SWI. This report focuses on two cases of WM inflammatory lesions enhancing on SWI images after CM injection. In these lesions in fact the CM increased the contrast between the parenchyma and the central vein allowing as well, in one of the two cases, the detection of a vein not visible on the same SWI sequence acquired before CM injection.

No MeSH data available.


Related in: MedlinePlus