Skip to main content
Erschienen in: European Radiology 8/2016

22.10.2015 | Neuro

Changes and variability of proton density and T1 relaxation times in early multiple sclerosis: MRI markers of neuronal damage in the cerebral cortex

verfasst von: René-Maxime Gracien, Sarah C. Reitz, Stephanie Michelle Hof, Vinzenz Fleischer, Hilga Zimmermann, Amgad Droby, Helmuth Steinmetz, Frauke Zipp, Ralf Deichmann, Johannes C. Klein

Erschienen in: European Radiology | Ausgabe 8/2016

Einloggen, um Zugang zu erhalten

Abstract

Objectives

Proton density (PD) and T1 relaxation time are promising quantitative MRI (qMRI) markers of neuronal damage in multiple sclerosis (MS). However, it is unknown whether cortical differences of these parameters between patients and controls exist in the early stages of disease. This study investigates cortical T1 and PD in early MS stages, hypothesizing that these are altered and display a high spatial variability.

Methods

Quantitative T1 and PD mapping was performed on 11 patients with clinically isolated syndrome (CIS)/early MS in remission and 11 healthy controls. The normal appearing cortical gray matter was extracted, lobar regions were identified, and mean values and standard deviations of both parameters were calculated within each region.

Results

Increased PD was detected in MS/CIS patients in the cerebral cortex as a whole and all subregions, indicating an increase of water content. Increase of PD variability reached significance in the whole cortex and in the frontal and parietal regions. Longer T1 relaxation times and increased variability were found in the cerebral cortex in all regions studied, indicating a change of microstructural tissue composition that is spatially heterogeneous.

Conclusions

The data show spatially heterogeneous cortical involvement in early MS is reflected in T1 and PD qMRI.

Key Points

Cortical involvement in early MS is reflected in T1/PD quantitative MRI.
The changes are spatially heterogeneous.
Cortical damage goes beyond increased water content.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M et al (2011) Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol 69:292–302CrossRefPubMedPubMedCentral Polman CH, Reingold SC, Banwell B, Clanet M, Cohen JA, Filippi M et al (2011) Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol 69:292–302CrossRefPubMedPubMedCentral
2.
Zurück zum Zitat Hajnal JV, de Coene B, Lewis PD, Baudouin CJ, Cowan FM, Pennock JM et al (1992) High signal regions in normal white matter shown by heavily T2-weighted CSF nulled IR sequences. J Comput Assist Tomogr 16:506–513CrossRefPubMed Hajnal JV, de Coene B, Lewis PD, Baudouin CJ, Cowan FM, Pennock JM et al (1992) High signal regions in normal white matter shown by heavily T2-weighted CSF nulled IR sequences. J Comput Assist Tomogr 16:506–513CrossRefPubMed
3.
Zurück zum Zitat Morrissey SP, Miller DH, Kendall BE, Kingsley DP, Kelly MA, Francis DA et al (1993) The significance of brain magnetic resonance imaging abnormalities at presentation with clinically isolated syndromes suggestive of multiple sclerosis. A 5-year follow-up study. Brain J Neurol 116:135–146CrossRef Morrissey SP, Miller DH, Kendall BE, Kingsley DP, Kelly MA, Francis DA et al (1993) The significance of brain magnetic resonance imaging abnormalities at presentation with clinically isolated syndromes suggestive of multiple sclerosis. A 5-year follow-up study. Brain J Neurol 116:135–146CrossRef
4.
Zurück zum Zitat Droby A, Lukas C, Schänzer A, Spiwoks-Becker I, Giorgio A, Gold R et al (2015) A human post-mortem brain model for the standardization of multi-centre MRI studies. NeuroImage 110C:11–21CrossRef Droby A, Lukas C, Schänzer A, Spiwoks-Becker I, Giorgio A, Gold R et al (2015) A human post-mortem brain model for the standardization of multi-centre MRI studies. NeuroImage 110C:11–21CrossRef
5.
Zurück zum Zitat Tofts P (ed) (2003) Quantitative MRI of the brain: measuring changes caused by disease: measuring changes caused by disease. John Wiley and Sons Ltd Tofts P (ed) (2003) Quantitative MRI of the brain: measuring changes caused by disease: measuring changes caused by disease. John Wiley and Sons Ltd
6.
Zurück zum Zitat Zipp F, Gold R, Wiendl H (2013) Identification of inflammatory neuronal injury and prevention of neuronal damage in multiple sclerosis: hope for novel therapies? JAMA Neurol 70:1569–1574PubMed Zipp F, Gold R, Wiendl H (2013) Identification of inflammatory neuronal injury and prevention of neuronal damage in multiple sclerosis: hope for novel therapies? JAMA Neurol 70:1569–1574PubMed
7.
Zurück zum Zitat Siffrin V, Vogt J, Radbruch H, Nitsch R, Zipp F (2010) Multiple sclerosis - candidate mechanisms underlying CNS atrophy. Trends Neurosci 33:202–210CrossRefPubMed Siffrin V, Vogt J, Radbruch H, Nitsch R, Zipp F (2010) Multiple sclerosis - candidate mechanisms underlying CNS atrophy. Trends Neurosci 33:202–210CrossRefPubMed
8.
Zurück zum Zitat Filippi M, Rocca MA, Barkhof F, Brück W, Chen JT, Comi G et al (2012) Association between pathological and MRI findings in multiple sclerosis. Lancet Neurol 11:349–360CrossRefPubMed Filippi M, Rocca MA, Barkhof F, Brück W, Chen JT, Comi G et al (2012) Association between pathological and MRI findings in multiple sclerosis. Lancet Neurol 11:349–360CrossRefPubMed
9.
Zurück zum Zitat Crespy L, Zaaraoui W, Lemaire M, Rico A, Faivre A, Reuter F et al (2011) Prevalence of grey matter pathology in early multiple sclerosis assessed by magnetization transfer ratio imaging. PLoS One 6:e24969CrossRefPubMedPubMedCentral Crespy L, Zaaraoui W, Lemaire M, Rico A, Faivre A, Reuter F et al (2011) Prevalence of grey matter pathology in early multiple sclerosis assessed by magnetization transfer ratio imaging. PLoS One 6:e24969CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Burgetova A, Seidl Z, Krasensky J, Horakova D, Vaneckova M (2010) Multiple sclerosis and the accumulation of iron in the Basal Ganglia: quantitative assessment of brain iron using MRI t(2) relaxometry. Eur Neurol 63:136–143CrossRefPubMed Burgetova A, Seidl Z, Krasensky J, Horakova D, Vaneckova M (2010) Multiple sclerosis and the accumulation of iron in the Basal Ganglia: quantitative assessment of brain iron using MRI t(2) relaxometry. Eur Neurol 63:136–143CrossRefPubMed
11.
Zurück zum Zitat Cercignani M, Bozzali M, Iannucci G, Comi G, Filippi M (2001) Magnetisation transfer ratio and mean diffusivity of normal appearing white and grey matter from patients with multiple sclerosis. J Neurol Neurosurg Psychiatry 70:311–317CrossRefPubMedPubMedCentral Cercignani M, Bozzali M, Iannucci G, Comi G, Filippi M (2001) Magnetisation transfer ratio and mean diffusivity of normal appearing white and grey matter from patients with multiple sclerosis. J Neurol Neurosurg Psychiatry 70:311–317CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Sarchielli P, Presciutti O, Tarducci R, Gobbi G, Alberti A, Pelliccioli GP et al (2002) Localized (1)H magnetic resonance spectroscopy in mainly cortical gray matter of patients with multiple sclerosis. J Neurol 249:902–910CrossRefPubMed Sarchielli P, Presciutti O, Tarducci R, Gobbi G, Alberti A, Pelliccioli GP et al (2002) Localized (1)H magnetic resonance spectroscopy in mainly cortical gray matter of patients with multiple sclerosis. J Neurol 249:902–910CrossRefPubMed
13.
Zurück zum Zitat Griffin CM, Chard DT, Parker GJM, Barker GJ, Thompson AJ, Miller DH (2002) The relationship between lesion and normal appearing brain tissue abnormalities in early relapsing remitting multiple sclerosis. J Neurol 249:193–199CrossRefPubMed Griffin CM, Chard DT, Parker GJM, Barker GJ, Thompson AJ, Miller DH (2002) The relationship between lesion and normal appearing brain tissue abnormalities in early relapsing remitting multiple sclerosis. J Neurol 249:193–199CrossRefPubMed
14.
Zurück zum Zitat Griffin CM, Dehmeshki J, Chard DT, Parker GJM, Barker GJ, Thompson AJ et al (2002) T1 histograms of normal-appearing brain tissue are abnormal in early relapsing-remitting multiple sclerosis. Mult Scler (Houndmills, Basingstoke, Engl) 8:211–216CrossRef Griffin CM, Dehmeshki J, Chard DT, Parker GJM, Barker GJ, Thompson AJ et al (2002) T1 histograms of normal-appearing brain tissue are abnormal in early relapsing-remitting multiple sclerosis. Mult Scler (Houndmills, Basingstoke, Engl) 8:211–216CrossRef
15.
Zurück zum Zitat Vrenken H, Geurts, Jeroen J G, Knol DL, van Dijk, L Noor, Dattola V, Jasperse B et al (2006) Whole-brain T1 mapping in multiple sclerosis: global changes of normal-appearing gray and white matter. Radiology 240(3):811–20 Vrenken H, Geurts, Jeroen J G, Knol DL, van Dijk, L Noor, Dattola V, Jasperse B et al (2006) Whole-brain T1 mapping in multiple sclerosis: global changes of normal-appearing gray and white matter. Radiology 240(3):811–20
16.
Zurück zum Zitat Hasan KM, Walimuni IS, Abid H, Datta S, Wolinsky JS, Narayana PA (2012) Human brain atlas-based multimodal MRI analysis of volumetry, diffusimetry, relaxometry and lesion distribution in multiple sclerosis patients and healthy adult controls: implications for understanding the pathogenesis of multiple sclerosis and consolidation of quantitative MRI results in MS. J Neurol Sci 313:99–109CrossRefPubMed Hasan KM, Walimuni IS, Abid H, Datta S, Wolinsky JS, Narayana PA (2012) Human brain atlas-based multimodal MRI analysis of volumetry, diffusimetry, relaxometry and lesion distribution in multiple sclerosis patients and healthy adult controls: implications for understanding the pathogenesis of multiple sclerosis and consolidation of quantitative MRI results in MS. J Neurol Sci 313:99–109CrossRefPubMed
17.
Zurück zum Zitat Bluestein KT, Pitt D, Knopp MV, Schmalbrock P (2012) T1 and proton density at 7 T in patients with multiple sclerosis: an initial study. Magn Reson Imaging 30:19–25CrossRefPubMed Bluestein KT, Pitt D, Knopp MV, Schmalbrock P (2012) T1 and proton density at 7 T in patients with multiple sclerosis: an initial study. Magn Reson Imaging 30:19–25CrossRefPubMed
18.
Zurück zum Zitat Engström M, Warntjes JBM, Tisell A, Landtblom A, Lundberg P (2014) Multi-parametric representation of voxel-based quantitative magnetic resonance imaging. PLoS One 9:e111688CrossRefPubMedPubMedCentral Engström M, Warntjes JBM, Tisell A, Landtblom A, Lundberg P (2014) Multi-parametric representation of voxel-based quantitative magnetic resonance imaging. PLoS One 9:e111688CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Chard D, Miller D (2009) Grey matter pathology in clinically early multiple sclerosis: evidence from magnetic resonance imaging. J Neurol Sci 282:5–11CrossRefPubMed Chard D, Miller D (2009) Grey matter pathology in clinically early multiple sclerosis: evidence from magnetic resonance imaging. J Neurol Sci 282:5–11CrossRefPubMed
20.
Zurück zum Zitat Venkatesan R, Lin W, Haacke EM (1998) Accurate determination of spin-density and T1 in the presence of RF-field inhomogeneities and flip-angle miscalibration. Magn Reson Med Off J Soc Magn Reson Med Soc Magn Reson Med 40:592–602CrossRef Venkatesan R, Lin W, Haacke EM (1998) Accurate determination of spin-density and T1 in the presence of RF-field inhomogeneities and flip-angle miscalibration. Magn Reson Med Off J Soc Magn Reson Med Soc Magn Reson Med 40:592–602CrossRef
21.
Zurück zum Zitat Preibisch C, Deichmann R (2009) T1 mapping using spoiled FLASH-EPI hybrid sequences and varying flip angles. Magn Reson Med Off J Soc Magn Reson Med Soc Magn Reson Med 62:240–246CrossRef Preibisch C, Deichmann R (2009) T1 mapping using spoiled FLASH-EPI hybrid sequences and varying flip angles. Magn Reson Med Off J Soc Magn Reson Med Soc Magn Reson Med 62:240–246CrossRef
22.
Zurück zum Zitat Volz S, Nöth U, Rotarska-Jagiela A, Deichmann R (2010) A fast B1-mapping method for the correction and normalization of magnetization transfer ratio maps at 3 T. NeuroImage 49:3015–3026CrossRefPubMed Volz S, Nöth U, Rotarska-Jagiela A, Deichmann R (2010) A fast B1-mapping method for the correction and normalization of magnetization transfer ratio maps at 3 T. NeuroImage 49:3015–3026CrossRefPubMed
23.
Zurück zum Zitat Mugler JP, Brookeman JR (1990) Three-dimensional magnetization-prepared rapid gradient-echo imaging (3D MP RAGE). Magn Reson Med Off J Soc Magn Reson Med Soc Magn Reson Med 15:152–157CrossRef Mugler JP, Brookeman JR (1990) Three-dimensional magnetization-prepared rapid gradient-echo imaging (3D MP RAGE). Magn Reson Med Off J Soc Magn Reson Med Soc Magn Reson Med 15:152–157CrossRef
24.
Zurück zum Zitat Smith SM, Jenkinson M, Woolrich MW, Beckmann CF, Behrens TEJ, Johansen-Berg H et al (2004) Advances in functional and structural MR image analysis and implementation as FSL. NeuroImage 23:S208–S219CrossRefPubMed Smith SM, Jenkinson M, Woolrich MW, Beckmann CF, Behrens TEJ, Johansen-Berg H et al (2004) Advances in functional and structural MR image analysis and implementation as FSL. NeuroImage 23:S208–S219CrossRefPubMed
25.
Zurück zum Zitat Preibisch C, Deichmann R (2009) Influence of RF spoiling on the stability and accuracy of T1 mapping based on spoiled FLASH with varying flip angles. Magn Reson Med Off J Soc Magn Reson Med Soc Magn Reson Med 61:125–135CrossRef Preibisch C, Deichmann R (2009) Influence of RF spoiling on the stability and accuracy of T1 mapping based on spoiled FLASH with varying flip angles. Magn Reson Med Off J Soc Magn Reson Med Soc Magn Reson Med 61:125–135CrossRef
26.
Zurück zum Zitat Volz S, Nöth U, Deichmann R (2012) Correction of systematic errors in quantitative proton density mapping. Magn Reson Med Off J Soc Magn Reson Med Soc Magn Reson Med 68:74–85CrossRef Volz S, Nöth U, Deichmann R (2012) Correction of systematic errors in quantitative proton density mapping. Magn Reson Med Off J Soc Magn Reson Med Soc Magn Reson Med 68:74–85CrossRef
27.
Zurück zum Zitat Volz S, Nöth U, Jurcoane A, Ziemann U, Hattingen E, Deichmann R (2012) Quantitative proton density mapping: correcting the receiver sensitivity bias via pseudo proton densities. NeuroImage 63:540–552CrossRefPubMed Volz S, Nöth U, Jurcoane A, Ziemann U, Hattingen E, Deichmann R (2012) Quantitative proton density mapping: correcting the receiver sensitivity bias via pseudo proton densities. NeuroImage 63:540–552CrossRefPubMed
28.
Zurück zum Zitat Fatouros PP, Marmarou A, Kraft KA, Inao S, Schwarz FP (1991) In vivo brain water determination by T1 measurements: effect of total water content, hydration fraction, and field strength. Magn Reson Med 17:402–413CrossRefPubMed Fatouros PP, Marmarou A, Kraft KA, Inao S, Schwarz FP (1991) In vivo brain water determination by T1 measurements: effect of total water content, hydration fraction, and field strength. Magn Reson Med 17:402–413CrossRefPubMed
29.
Zurück zum Zitat Zhang Y, Brady M, Smith S (2001) Segmentation of brain MR images through a hidden Markov random field model and the expectation-maximization algorithm. IEEE Trans Med Imaging 20:45–57CrossRefPubMed Zhang Y, Brady M, Smith S (2001) Segmentation of brain MR images through a hidden Markov random field model and the expectation-maximization algorithm. IEEE Trans Med Imaging 20:45–57CrossRefPubMed
30.
Zurück zum Zitat Wansapura JP, Holland SK, Dunn RS, Ball WS (1999) NMR relaxation times in the human brain at 3.0 tesla. J Magn Reson Imaging JMRI 9:531–538CrossRefPubMed Wansapura JP, Holland SK, Dunn RS, Ball WS (1999) NMR relaxation times in the human brain at 3.0 tesla. J Magn Reson Imaging JMRI 9:531–538CrossRefPubMed
31.
Zurück zum Zitat Brex PA, Parker GJ, Leary SM, Molyneux PD, Barker GJ, Davie CA et al (2000) Lesion heterogeneity in multiple sclerosis: a study of the relations between appearances on T1 weighted images, T1 relaxation times, and metabolite concentrations. J Neurol Neurosurg Psychiatry 68:627–632CrossRefPubMedPubMedCentral Brex PA, Parker GJ, Leary SM, Molyneux PD, Barker GJ, Davie CA et al (2000) Lesion heterogeneity in multiple sclerosis: a study of the relations between appearances on T1 weighted images, T1 relaxation times, and metabolite concentrations. J Neurol Neurosurg Psychiatry 68:627–632CrossRefPubMedPubMedCentral
32.
Zurück zum Zitat van Walderveen MA, Barkhof F, Pouwels PJ, van Schijndel RA, Polman CH, Castelijns JA (1999) Neuronal damage in T1-hypointense multiple sclerosis lesions demonstrated in vivo using proton magnetic resonance spectroscopy. Ann Neurol 46:79–87CrossRefPubMed van Walderveen MA, Barkhof F, Pouwels PJ, van Schijndel RA, Polman CH, Castelijns JA (1999) Neuronal damage in T1-hypointense multiple sclerosis lesions demonstrated in vivo using proton magnetic resonance spectroscopy. Ann Neurol 46:79–87CrossRefPubMed
33.
Zurück zum Zitat Papadopoulos K, Tozer DJ, Fisniku L, Altmann DR, Davies G, Rashid W et al (2010) TI-relaxation time changes over five years in relapsing-remitting multiple sclerosis. Mult Scler (Houndmills, Basingstoke, Engl) 16:427–433CrossRef Papadopoulos K, Tozer DJ, Fisniku L, Altmann DR, Davies G, Rashid W et al (2010) TI-relaxation time changes over five years in relapsing-remitting multiple sclerosis. Mult Scler (Houndmills, Basingstoke, Engl) 16:427–433CrossRef
34.
Zurück zum Zitat Molyneux PD, Filippi M, Barkhof F, Gasperini C, Yousry TA, Truyen L et al (1998) Correlations between monthly enhanced MRI lesion rate and changes in T2 lesion volume in multiple sclerosis. Ann Neurol 43:332–339CrossRefPubMed Molyneux PD, Filippi M, Barkhof F, Gasperini C, Yousry TA, Truyen L et al (1998) Correlations between monthly enhanced MRI lesion rate and changes in T2 lesion volume in multiple sclerosis. Ann Neurol 43:332–339CrossRefPubMed
35.
Zurück zum Zitat Fazekas F, Bajenaru O, Berger T, Fabjan TH, Ledinek AH, Jakab G et al (2013) How does fingolimod (gilenya(®)) fit in the treatment algorithm for highly active relapsing-remitting multiple sclerosis? Front Neurol 4:10CrossRefPubMedPubMedCentral Fazekas F, Bajenaru O, Berger T, Fabjan TH, Ledinek AH, Jakab G et al (2013) How does fingolimod (gilenya(®)) fit in the treatment algorithm for highly active relapsing-remitting multiple sclerosis? Front Neurol 4:10CrossRefPubMedPubMedCentral
36.
Zurück zum Zitat Naruse S, Horikawa Y, Tanaka C, Hirakawa K, Nishikawa H, Yoshizaki K (1981) Nuclear magnetic resonance studies on brain edema--time course of 1H-NMR relaxation times (author's transl). Nō to Shinkei Brain Nerve 33:569–575PubMed Naruse S, Horikawa Y, Tanaka C, Hirakawa K, Nishikawa H, Yoshizaki K (1981) Nuclear magnetic resonance studies on brain edema--time course of 1H-NMR relaxation times (author's transl). Nō to Shinkei Brain Nerve 33:569–575PubMed
37.
Zurück zum Zitat Miller DH, Thompson AJ, Filippi M (2003) Magnetic resonance studies of abnormalities in the normal appearing white matter and grey matter in multiple sclerosis. J Neurol 250:1407–1419CrossRefPubMed Miller DH, Thompson AJ, Filippi M (2003) Magnetic resonance studies of abnormalities in the normal appearing white matter and grey matter in multiple sclerosis. J Neurol 250:1407–1419CrossRefPubMed
38.
Zurück zum Zitat Politis M, Giannetti P, Su P, Turkheimer F, Keihaninejad S, Wu K et al (2012) Increased PK11195 PET binding in the cortex of patients with MS correlates with disability. Neurology 79:523–530CrossRefPubMedPubMedCentral Politis M, Giannetti P, Su P, Turkheimer F, Keihaninejad S, Wu K et al (2012) Increased PK11195 PET binding in the cortex of patients with MS correlates with disability. Neurology 79:523–530CrossRefPubMedPubMedCentral
39.
Zurück zum Zitat Nöth U, Hattingen E, Bähr O, Tichy J, Deichmann R (2015) Improved visibility of brain tumors in synthetic MP-RAGE anatomies with pure T1 weighting. NMR Biomed 28:818–830CrossRefPubMed Nöth U, Hattingen E, Bähr O, Tichy J, Deichmann R (2015) Improved visibility of brain tumors in synthetic MP-RAGE anatomies with pure T1 weighting. NMR Biomed 28:818–830CrossRefPubMed
40.
Zurück zum Zitat Calabrese M, Magliozzi R, Ciccarelli O, Geurts JJG, Reynolds R, Martin R (2015) Exploring the origins of grey matter damage in multiple sclerosis. Nat Rev Neurosci 16:147–158CrossRefPubMed Calabrese M, Magliozzi R, Ciccarelli O, Geurts JJG, Reynolds R, Martin R (2015) Exploring the origins of grey matter damage in multiple sclerosis. Nat Rev Neurosci 16:147–158CrossRefPubMed
41.
Zurück zum Zitat Pellicano C, Gallo A, Li X, Ikonomidou VN, Evangelou IE, Ohayon JM et al (2010) Relationship of cortical atrophy to fatigue in patients with multiple sclerosis. Arch Neurol 67:447–453CrossRefPubMed Pellicano C, Gallo A, Li X, Ikonomidou VN, Evangelou IE, Ohayon JM et al (2010) Relationship of cortical atrophy to fatigue in patients with multiple sclerosis. Arch Neurol 67:447–453CrossRefPubMed
42.
Zurück zum Zitat Gobbi C, Rocca MA, Riccitelli G, Pagani E, Messina R, Preziosa P et al (2014) Influence of the topography of brain damage on depression and fatigue in patients with multiple sclerosis. Mult Scler (Houndmills, Basingstoke, Engl) 20:192–201CrossRef Gobbi C, Rocca MA, Riccitelli G, Pagani E, Messina R, Preziosa P et al (2014) Influence of the topography of brain damage on depression and fatigue in patients with multiple sclerosis. Mult Scler (Houndmills, Basingstoke, Engl) 20:192–201CrossRef
43.
Zurück zum Zitat Calabrese M, Agosta F, Rinaldi F, Mattisi I, Grossi P, Favaretto A et al (2009) Cortical lesions and atrophy associated with cognitive impairment in relapsing-remitting multiple sclerosis. Arch Neurol 66:1144–1150CrossRefPubMed Calabrese M, Agosta F, Rinaldi F, Mattisi I, Grossi P, Favaretto A et al (2009) Cortical lesions and atrophy associated with cognitive impairment in relapsing-remitting multiple sclerosis. Arch Neurol 66:1144–1150CrossRefPubMed
Metadaten
Titel
Changes and variability of proton density and T1 relaxation times in early multiple sclerosis: MRI markers of neuronal damage in the cerebral cortex
verfasst von
René-Maxime Gracien
Sarah C. Reitz
Stephanie Michelle Hof
Vinzenz Fleischer
Hilga Zimmermann
Amgad Droby
Helmuth Steinmetz
Frauke Zipp
Ralf Deichmann
Johannes C. Klein
Publikationsdatum
22.10.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 8/2016
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-4072-x

Weitere Artikel der Ausgabe 8/2016

European Radiology 8/2016 Zur Ausgabe

Screening-Mammografie offenbart erhöhtes Herz-Kreislauf-Risiko

26.04.2024 Mammografie Nachrichten

Routinemäßige Mammografien helfen, Brustkrebs frühzeitig zu erkennen. Anhand der Röntgenuntersuchung lassen sich aber auch kardiovaskuläre Risikopatientinnen identifizieren. Als zuverlässiger Anhaltspunkt gilt die Verkalkung der Brustarterien.

S3-Leitlinie zu Pankreaskrebs aktualisiert

23.04.2024 Pankreaskarzinom Nachrichten

Die Empfehlungen zur Therapie des Pankreaskarzinoms wurden um zwei Off-Label-Anwendungen erweitert. Und auch im Bereich der Früherkennung gibt es Aktualisierungen.

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

18.04.2024 Pädiatrische Notfallmedizin Nachrichten

Im Choosing-Wisely-Programm, das für die deutsche Initiative „Klug entscheiden“ Pate gestanden hat, sind erstmals Empfehlungen zum Umgang mit Notfällen von Kindern erschienen. Fünf Dinge gilt es demnach zu vermeiden.

„Nur wer sich gut aufgehoben fühlt, kann auch für Patientensicherheit sorgen“

13.04.2024 Klinik aktuell Kongressbericht

Die Teilnehmer eines Forums beim DGIM-Kongress waren sich einig: Fehler in der Medizin sind häufig in ungeeigneten Prozessen und mangelnder Kommunikation begründet. Gespräche mit Patienten und im Team können helfen.

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.