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AJNR - American Journal of Neuroradiology

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Dynamic Susceptibility Contrast Perfusion MR Imaging of Multiple Sclerosis Lesions: Characterizing Hemodynamic Impairment and Inflammatory Activity

Yulin Ge^a, Meng Law^a, Glyn Johnson^a, Joseph Herbert^b, James S. Babb^a, Lois J. Mannon^a and Robert I. Grossman^a

^a Department of Radiology, New York University School of Medicine, New York, NY 10016
^b Department of Neurology, Hospital for Joint Disease, New York University School of Medicine, New York, NY 10016

View larger version (16K): [in a new window]   FIG 1. A K means cluster analysis applied to perfusion measures (CBF and CBV) of MS lesions results in the construction of 3 clusters of enhancing and non-enhancing lesion types and suggests a further classification of non-enhancing lesions into two subtypes (class 1 [characteristics distinct from enhancing lesions] and class 2 [characteristics similar to enhancing lesions]).

View larger version (54K): [in a new window]   FIG 2. CBF and CBV color-coded maps obtained in a patient with an enhancing lesion show increased perfusion (black arrows) in the enhancing lesion compared with perfusion in contralateral NAWM.

View larger version (112K): [in a new window]   FIG 3. CBF and MTT color-coded maps obtained in a patient with a nonenhancing lesion show decreased perfusion with decreased CBF and increased MTT (black arrows) compared with those measures in contralateral NAWM.

View larger version (115K): [in a new window]   FIG 4. CBF and CBV color-coded maps obtained in two patients with nonenhancing lesions show the various degree of increased perfusion (black arrows) in class 2 lesions compared with that of contralateral NAWM.

View larger version (22K): [in a new window]   FIG 5. Bar graphs show the mean ± SD of CBF (A) and CBV (B) in different types of lesions and all NAWM areas obtained in patients and measures in normal white matter (WM) areas obtained in control subjects. Despite the large overlap of CBV measurements between normal WM and those of lesions and NAWM, CBF is generally lower in both lesions and NAWM compared with normal WM in controls.