Abstract
SUMMARY: Using MR imaging, perfusion can be assessed either by dynamic susceptibility contrast MR imaging or arterial spin-labeling. Alterations of cerebral perfusion have repeatedly been described in multiple sclerosis compared with healthy controls. Acute lesions exhibit relative hyperperfusion in comparison with normal-appearing white matter, a finding mostly attributed to inflammation in this stage of lesion development. In contrast, normal-appearing white and gray matter of patients with MS has been mostly found to be hypoperfused compared with controls, and correlations with cognitive impairment as well as fatigue in multiple sclerosis have been described. Mitochondrial failure, axonal degeneration, and vascular dysfunction have been hypothesized to underlie the perfusion MR imaging findings. Clinically, perfusion MR imaging could allow earlier detection of the acute focal inflammatory changes underlying relapses and new lesions, and could constitute a marker for cognitive dysfunction in MS. Nevertheless, the clinical relevance and pathogenesis of the brain perfusion changes in MS remain to be clarified.
ABBREVIATIONS:
- ASL
- arterial spin-labeling
- DCE
- dynamic contrast-enhanced
- NAWM
- normal-appearing white matter
- RRMS
- relapsing-remitting MS
Footnotes
Disclosures: Emmanuelle Lapointe—UNRELATED: Consultancy: EMD Serono and Hoffmann-La Roche. Anthony L. Traboulsee—UNRELATED: Grant: Canadian Institute for Health Research*; UNRELATED: Consultancy: Biogen Idec, Hoffman-La Roche, Sanofi Genzyme, Novartis, Teva Canada Innovation; Grants/Grants Pending: MS Society of Canada, Chugai Pharmaceutical Co, Biogen Idec, Sanofi Genzyme, Hoffman-La Roche*; Payment for Lectures Including Service on Speakers Bureaus: Sanofi Genzyme, Hoffman-La Roche; Travel/Accommodations/Meeting Expenses Unrelated to Activities Listed: Sanofi Genzyme. Alexander Rauscher—UNRELATED: Payment for Lectures Including Service on Speakers Bureaus: Philips Healthcare, Comments: fees for a keynote lecture at a Philips MRI Lunch Symposia. *Money paid to the institution.
- © 2018 by American Journal of Neuroradiology
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