This Article Full Text (PDF) All Versions of this Article: 1352458508096876v1 15/2/180    most recent References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Web of Science (3) Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Gilmore, C. Articles by Bö, L Search for Related Content PubMed PubMed Citation Articles by Gilmore, C. Articles by Bö, L Social Bookmarking                         What's this?

Spinal cord grey matter lesions in multiple sclerosis detected by post-mortem high field MR imaging

Department of Neurology, Queens Medical Centre NHS Trust, Nottingham, UK UK.chris.gilmore{at}nottingham.ac.uk

JJG Geurts

Department of Neuropathology, VU Medical Centre, Amsterdam, The Netherlands; Department of Radiology, VU Medical Centre, Amsterdam, The Netherlands

N Evangelou

Department of Neurology, Queens Medical Centre NHS Trust, Nottingham, UK

JCJ Bot

Department of Radiology, VU Medical Centre, Amsterdam, The Netherlands

RA van Schijndel

Department of Radiology, VU Medical Centre, Amsterdam, The Netherlands

PJW Pouwels

Department of Physics and Medical Technology, VU Medical Centre, Amsterdam, The Netherlands

F Barkhof

Department of Radiology, VU Medical Centre, Amsterdam, The Netherlands

L Bö

Department of Neuropathology, VU Medical Centre, Amsterdam, The Netherlands; National Competence Centre for MS, Department of Neurology, Haukeland University Hospital, University of Bergen, Bergen, Norway

Background

Post-mortem studies demonstrate extensive grey matter demyelination in MS, both in the brain and in the spinal cord. However the clinical significance of these plaques is unclear, largely because they are grossly underestimated by MR imaging at conventional field strengths. Indeed post-mortem MR studies suggest the great majority of lesions in the cerebral cortex go undetected, even when performed at high field. Similar studies have not been performed using post-mortem spinal cord material.

Aim

To assess the sensitivity of high field post-mortem MRI for detecting grey matter lesions in the spinal cord in MS.

Methods

Autopsy material was obtained from 11 MS cases and 2 controls. Proton Density-weighted images of this formalin-fixed material were acquired at 4.7Tesla before the tissue was sectioned and stained for Myelin Basic Protein. Both the tissue sections and the MR images were scored for grey matter and white matter plaques, with the readers of the MR images being blinded to the histopathology results.

Results

Our results indicate that post-mortem imaging at 4.7Tesla is highly sensitive for cord lesions, detecting 87% of white matter lesions and 73% of grey matter lesions. The MR changes were highly specific for demyelination, with all lesions scored on MRI corresponding to areas of demyelination.

Conclusion

Our work suggests that spinal cord grey matter lesions may be detected on MRI more readily than GM lesions in the brain, making the cord a promising site to study the functional consequences of grey matter demyelination in MS.

Key Words: demyelination • Multiple sclerosis • MRI

This version was published on February 1, 2009

Multiple Sclerosis, Vol. 15, No. 2, 180-188 (2009)
DOI: 10.1177/1352458508096876


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?