| Post-mortem high-resolution MRI of the spinal cord in multiple sclerosis: a correlative study with conventional MRI, histopathology and clinical phenotype. | |
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MedLine Citation:
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PMID: 11133795 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We used high-resolution MRI to study the post-mortem appearance of spinal cord multiple sclerosis in relation to histopathology and low-resolution images. Fifty-nine 3 cm long formalin-fixed spinal cord specimens from 19 multiple sclerosis patients and three controls were studied. Clinical characteristics of each patient were reviewed. High-field MRI consisted of proton-density weighted spin-echo imaging with an in-plane resolution of 80 microm. Specimens were also imaged at 1.0 T, with 1 mm pixel resolution. After MRI, the specimens were cut at 5 mm intervals and stained for myelin (Luxol fast blue/cresyl violet) and axons (Bodian method). Two observers scored the MRIs for abnormalities and divided them into (i) well-delineated areas of high signal intensity (SI) and (ii) poorly defined areas of mildly increased SI. Abnormalities were scored semiquantitatively, white matter and grey matter separately. In 81 sections the total area of abnormalities per section was measured on both histopathology sections and on matched high-field MRIs. Abnormalities ranged from just a few abnormal areas to complete involvement of the spinal cord specimen. Patients with an aggressive disease course had more abnormalities than patients with a mild or intermediate disease course. Areas of mildly increased SI were seen in all specimens, and were often found around focal high-SI lesions. However, in six patients, areas of mildly increased SI were the predominant finding on the MRIs, correlating with a primary progressive disease course. Histopathologically, high-SI areas correlated with complete demyelination, while mildly increased SI corresponded with partial demyelination. All areas scored as abnormal by the neuropathologist were also found on the MRIs, and sizes measured using both methods correlated well (r = 0.85, P<0.01). On conventional MRIs, abnormalities could be recognized fairly well. However, better differentiation could be made between high-SI and mildly increased SI abnormalities on the 4.7 T images. In conclusion, high-resolution MRI revealed a great range of abnormalities in spinal cord multiple sclerosis, which related to disease course during life. Furthermore, we found very good correlation between the extent of abnormalities shown by histopathology and the SI changes on proton-density MRIs, mainly relating to demyelination revealed histopathologically. |
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Authors:
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G J Nijeholt; E Bergers; W Kamphorst; J Bot; K Nicolay; J A Castelijns; J H van Waesberghe; R Ravid; C H Polman; F Barkhof |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Brain : a journal of neurology Volume: 124 ISSN: 0006-8950 ISO Abbreviation: Brain Publication Date: 2001 Jan |
Date Detail:
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Created Date: 2001-01-30 Completed Date: 2001-02-08 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0372537 Medline TA: Brain Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 154-66 Citation Subset: AIM; IM |
Affiliation:
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Dutch MR Center for MS Research, Department of Radiology, Vrije Universiteit Hospital, Amsterdam, The Netherlands. g.lycklama@azvu.nl |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Disease Progression Female Humans Magnetic Resonance Imaging* / methods Male Middle Aged Multiple Sclerosis / classification*, diagnosis, pathology* Predictive Value of Tests Sensitivity and Specificity Spinal Cord / pathology* |
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