Highlights
- •Quantitative Susceptibility Mapping (QSM) is a susceptibility MRI technique used in MS
- •An outer rim on a QSM lesion may reflect chronic-active inflammation
- •Males are more likely to have rimmed QSM lesions than females
- •These radiologic findings may reflect sex-specific differences in MS pathophysiology
Abstract
Background
Susceptibility MRI techniques, such as phase and quantitative susceptibility mapping
(QSM) reveal lesion heterogeneity in MS, including the presence of lesions with outer
rims suggestive of iron accumulation in macrophages and microglia, indicative of chronic-active
inflammatory white matter lesions (WMLs).
Objective
To evaluate the in vivo relationship between chronic-active WMLs (as visualized by rimmed lesions on QSM)
and several clinical metrics.
Methods
39 patients (15 men, 24 women) with MS underwent 7 Tesla brain MRIs and clinical evaluation.
Contrast patterns of lesions identified on FLAIR and quantitative susceptibility maps
were reviewed and compared to demographic characteristics and disability scores.
Results
1279 lesions were identified on FLAIR MRI; 846 (66.2%) of these were visible on QSM,
119 (14.1%) of which had visible rims. Lesions visible on QSM were more likely to
have rims in men (16.1%, vs 4.9% in women, p=0.009). In a logistic regression model
accounting for several factors, male sex conferred a >10-fold risk of having ≥1 rimmed
lesion(s) (p=0.026).
Conclusion
Our findings provide in vivo support for the body of histopathologic literature indicating sex-specific differences
in MS WML formation and suggest that QSM can be used to study these sex differences
in the future.
Keywords
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Article info
Publication history
Published online: June 17, 2020
Accepted:
June 16,
2020
Received in revised form:
May 11,
2020
Received:
February 23,
2020
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
