By Mohammad Ali Sahraian, Ernst-Wilhelm Radue (auth.), Ernst-Wilhelm Radü, Mohammad Ali Sahraian (eds.)
MRI has develop into the most paraclinical try out within the analysis and administration of a number of sclerosis. we've got proven greater than four hundred photos of other commonplace and extraordinary MS lesions during this atlas. each one photo has a instructing aspect. New diagnostic standards and differential analysis were discussed.
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Extra resources for MRI Atlas of MS Lesions
The only exception might be the “open-ring” sign for differentiating large, tumor-like demyelinating lesions from actual tumors and infections. These lesions create an incomplete ring and typically the open section is orientated toward the gray matter or is adjacent to it (Bitsch and Bruck 2002). Most Gd enhancing lesions are clinically silent. Thus, MRI has become an important tool for supporting an early and accurate diagnosis of MS in many patients. Analysis of studies suggests that Gd enhancement is not a marker of later disability or functional impairment in long-term follow up (Kappos et al.
1998). Two other disadvantages of FLAIR MR sequences are CSF flow artifacts and the long acquisition time required for imaging an only limited number of slices. Pulsatile CSF flow generates inflow effects in the selected slice during the inversion time interval, which causes incomplete nulling of CSF signal intensities, and may produce hyperintense artifacts in areas of prominent CSF pulsation, like the foramen of Monro and third and fourth ventricles (Bakshi et al. 2000). The limitation of long acquisition time has been overcome by applying fast spin-echo images (Rydberg et al.
2005) if the lesion is not at the site corresponding to the initial event. Steroid treatment may strongly suppress appearance of enhancing lesions, whereas larger Gd dosage may increase sensitivity of bloodbrain barrier leakage. This could result in re- 46 3 Gadolinium Enhancing Lesions in Multiple Sclerosis duced pathological specificity because even old and inactive lesions can show faint enhancement (Bitsch and Bruck 2002). In this chapter we demonstrate different patterns of enhancing lesions in various parts of the brain.