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Weber CE, Krämer J, Wittayer M, et al. Association of iron rim lesions with brain and cervical cord volume in relapsing multiple sclerosis. Eur Radiol. 2021;doi: 10.1007/s00330-021-08233-w.
Weber, C. E., Krämer, J., Wittayer, M., Gregori, J., Randoll, S., Weiler, F., Heldmann, S., Roßmanith, C., Platten, M., Gass, A., & Eisele, P. (2021). Association of iron rim lesions with brain and cervical cord volume in relapsing multiple sclerosis. European radiology, . https://doi.org/10.1007/s00330-021-08233-w
Weber, Claudia E, et al. "Association of iron rim lesions with brain and cervical cord volume in relapsing multiple sclerosis." European radiology vol. (2021). doi: https://doi.org/10.1007/s00330-021-08233-w
Weber CE, Krämer J, Wittayer M, Gregori J, Randoll S, Weiler F, Heldmann S, Roßmanith C, Platten M, Gass A, Eisele P. Association of iron rim lesions with brain and cervical cord volume in relapsing multiple sclerosis. Eur Radiol. 2021 Sep 22; doi: 10.1007/s00330-021-08233-w. Epub 2021 Sep 22. PMID: 34549326.
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Eur Radiol. 2021 Sep 22; doi: 10.1007/s00330-021-08233-w. Epub 2021 Sep 22.

Association of iron rim lesions with brain and cervical cord volume in relapsing multiple sclerosis.

European radiology

Claudia E Weber, Julia Krämer, Matthias Wittayer, Johannes Gregori, Sigurd Randoll, Florian Weiler, Stefan Heldmann, Christina Roßmanith, Michael Platten, Achim Gass, Philipp Eisele

Affiliations

  1. Department of Neurology, Medical Faculty Mannheim and Mannheim Center for Translational Neurosciences (MCTN), University of Heidelberg, Theodor-Kutzer-Ufer 1 - 3, 68167, Mannheim, Germany.
  2. Department of Neurology With Institute of Translational Neurology, University Hospital Münster, Albert-Schweitzer-Campus 1; Gebäude A1, Westturm, Ebene 5, 48149, Münster, Germany.
  3. Mediri GmbH, Eppelheimer Straße 113, 69115, Heidelberg, Germany.
  4. Fraunhofer MEVIS, Am Fallturm 1, 28359, Bremen, Germany.
  5. Department of Neurology, Medical Faculty Mannheim and Mannheim Center for Translational Neurosciences (MCTN), University of Heidelberg, Theodor-Kutzer-Ufer 1 - 3, 68167, Mannheim, Germany. [email protected].

PMID: 34549326 DOI: 10.1007/s00330-021-08233-w

Abstract

OBJECTIVES: In multiple sclerosis (MS), iron rim lesions (IRLs) are indicators of chronic low-grade inflammation and ongoing tissue destruction. The aim of this study was to assess the relationship of IRLs with clinical measures and magnetic resonance imaging (MRI) markers, in particular brain and cervical cord volume.

METHODS: Clinical and MRI parameters from 102 relapsing MS patients (no relapses for at least 6 months, no contrast-enhancing lesions) were included; follow-up data obtained after 12 months was available in 49 patients. IRLs were identified on susceptibility-weighted images (SWIs). In addition to standard brain and spinal cord MRI parameters, normalised cross-sectional area (nCSA) of the upper cervical cord was calculated.

RESULTS: Thirty-eight patients had at least one IRL on SWI MRI. At baseline, patients with IRLs had higher EDSS scores, higher lesion loads (brain and spinal cord), and lower cortical grey matter volumes and a lower nCSA. At follow-up, brain atrophy rates were higher in patients with IRLs. IRLs correlated spatially with T1-hypointense lesions.

CONCLUSIONS: Relapsing MS patients with IRLs showed more aggressive MRI disease characteristics in both the cross-sectional and longitudinal analyses.

KEY POINTS: • Multiple sclerosis patients with iron rim lesions had higher EDSS scores, higher brain and spinal cord lesion loads, lower cortical grey matter volumes, and a lower normalised cross-sectional area of the upper cervical spinal cord. • Iron rim lesions are a new lesion descriptor obtained from susceptibility-weighted MRI. Our data suggests that further exploration of this lesion characteristic in regard to a poorer prognosis in multiple sclerosis patients is warranted.

© 2021. The Author(s).

Keywords: Magnetic resonance imaging; Multiple sclerosis; Spinal cord

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