[PMID]: | 28283598 |
[Au] Autor: | Absinta M; Cortese IC; Vuolo L; Nair G; de Alwis MP; Ohayon J; Meani A; Martinelli V; Scotti R; Falini A; Smith BR; Nath A; Jacobson S; Filippi M; Reich DS |
[Ad] Endereço: | From the Division of Neuroimmunology and Neurovirology (M.A., I.C.M.C., L.V., G.N., M.P.d.A., J.O., B.R.S., A.N., S.J., D.S.R.), National Institute of Neurological Disorders and Stroke, NIH, Bethesda, MD; and the Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscien |
[Ti] Título: | Leptomeningeal gadolinium enhancement across the spectrum of chronic neuroinflammatory diseases. |
[So] Source: | Neurology;88(15):1439-1444, 2017 Apr 11. |
[Is] ISSN: | 1526-632X |
[Cp] País de publicação: | United States |
[La] Idioma: | eng |
[Ab] Resumo: | OBJECTIVE: To assess the prevalence and the specificity of leptomeningeal enhancement (LME) on postcontrast T2-fluid-attenuated inversion recovery (FLAIR) MRI in multiple sclerosis (MS) compared to a variety of inflammatory and noninflammatory neurologic conditions assessed in 2 academic research hospitals. METHODS: On 3T postcontrast T2-FLAIR images, the presence of focal gadolinium enhancement was evaluated in the leptomeningeal compartment in 254 people with non-MS neurologic conditions or neurotropic viral infections. Based on their clinical diagnosis, patients were grouped as follows: (1) other-than-MS inflammatory neurologic diseases; (2) noninflammatory neurologic diseases; (3) human T-lymphotropic virus (HTLV)-infected; (4) HIV-infected; (5) healthy volunteers. RESULTS: LME was detected in 56/254 non-MS cases (22%) vs 74/299 (25%) of MS cases. LME was nearly 4-fold more frequent in non-MS inflammatory neurologic conditions (18/51 cases, 35%) than in noninflammatory neurologic conditions (3/38, 8%) and healthy volunteers (5/66, 8%). The highest prevalence of LME was detected in HTLV infection (17/38 cases, 45%), particularly in the setting of HTLV-associated myelopathy (14/25 cases, 56%). LME also frequently occurred in HIV infection (13/61 cases, 21%). Unlike in MS, LME is not associated with lower brain and cortical volumes in non-MS inflammatory neurologic conditions, including HTLV and HIV infection. CONCLUSIONS: Despite its relevance to MS pathogenesis and cortical pathology, LME is not specific to MS, occurring frequently in non-MS inflammatory neurologic conditions and especially in those patients with HTLV-associated myelopathy. Overall, this strengthens the notion that LME localizes inflammation-related focal disruption of the blood-meninges barrier and associated scarring. |
[Mh] Termos MeSH primário: |
Encefalite/diagnóstico por imagem Encefalite/patologia Gadolínio/metabolismo Imagem por Ressonância Magnética Meninges/diagnóstico por imagem
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[Mh] Termos MeSH secundário: |
Adulto Idoso Estudos de Coortes Estudos Transversais Encefalite/líquido cefalorraquidiano Feminino Infecções por HIV/líquido cefalorraquidiano Infecções por HIV/diagnóstico por imagem Seres Humanos Imagem Tridimensional Contagem de Leucócitos Modelos Lineares Masculino Meia-Idade Esclerose Múltipla Recidivante-Remitente/líquido cefalorraquidiano Esclerose Múltipla Recidivante-Remitente/diagnóstico por imagem Doenças do Sistema Nervoso/líquido cefalorraquidiano Doenças do Sistema Nervoso/diagnóstico por imagem Bandas Oligoclonais/líquido cefalorraquidiano Adulto Jovem
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[Pt] Tipo de publicação: | JOURNAL ARTICLE; MULTICENTER STUDY |
[Nm] Nome de substância:
| 0 (Oligoclonal Bands); AU0V1LM3JT (Gadolinium) |
[Em] Mês de entrada: | 1705 |
[Cu] Atualização por classe: | 170523 |
[Lr] Data última revisão:
| 170523 |
[Sb] Subgrupo de revista: | AIM; IM |
[Da] Data de entrada para processamento: | 170312 |
[St] Status: | MEDLINE |
[do] DOI: | 10.1212/WNL.0000000000003820 |
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