Klaus and Amy MRI 6th MS Research Day
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Transcript of Klaus and Amy MRI 6th MS Research Day
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http://blizard.qmul.ac.uk/
Klaus Schmierer
& Amy McDowell
Using MRI as a research tool
MS Research Day, 21 Mar 2015
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What does MRI add over and above what…
…provide
- History
- Examination
- Pathology
- Epidemiology
- Blood & spinal fluid tests
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Making the diagnosis of MS
quicker and more accurate
MRI as a research tool: Example 1
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“To be suggestive of MS
lesions have to be disseminated
in space and time.
And there must be no better
explanation.”Ian McDonald1933 – 2006
McDonald criteria
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Swanton JK, et al. JNNP 2006
Lesions in different locations
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Swanton JK, et al. JNNP 2006
Lesions developing over time
≥30 days
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2010 revision of ‘McDonald’ criteria
Polman, et al. Ann Neurol 2011
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MS under the microscopeThe veins in MS Lesions
Schmierer, et al. Ann Neurol 2004
The blood in
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Vein scan (T2*) Lesion scan (FLAIR)
Lesions & veins
(FLAIR*)
Sati, et al. Radiology 2012
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The
Central Vein
sign
o n= 25 pwRMS
o 14 men;11 women
o age 41 ± 11.2 y
o RRMS for 7 ± 5.3 y
o MRI @ 3T:
o 3D FLAIR (after Gd
injection), 3D T2
and T2*
Tom CampionMarc Miquel & Campion, et al. AAN 2015 & ASNR 2015
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• 338 lesions deteced (13.5 ± 7)
• Proportion of CVS+ lesions: 88%
• All patients met MS criterion (≥45% CVS+)
• 3/25 fulfilled McDonald criteria using a single MRI head scan.
Results – FLAIR* in MS
Campion, et al. AAN 2015 & ASNR 2015
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Detect CNS changes better than by recording symptoms/ examination in clinic
MRI as a research tool: Example 2
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T2
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“Myelin images” of the brain
Standard image “Myelin water” mapLaule 2004
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Assessing normal white matter and MS lesions using “Myelin Water Fraction” MRI
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Myelin imaging using “short T2”
Tobias Wood
Amy McDowell
Gareth Barker
McDowell, et al. ISMRM 2015
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Acknowledgements
http://multiple-sclerosis-research.blogspot.com/