7 Tesla MRI of Balo's concentric sclerosis versus multiple sclerosis lesions
Authors
- J.R. Behrens
- J. Wanner
- J. Kuchling
- L. Ostendorf
- L. Harms
- K. Ruprecht
- T. Niendorf
- S. Jarius
- B. Wildemann
- R.M. Gieß
- M. Scheel
- J. Bellmann-Strobl
- J. Wuerfel
- F. Paul
- T. Sinnecker
Journal
- Annals of Clinical and Translational Neurology
Citation
- Ann Clin Transl Neurol 5 (8): 900-912
Abstract
BACKGROUND: Baló's concentric sclerosis (BCS) is a rare condition characterized by concentrically layered white matter lesions. While its pathogenesis is unknown, hypoxia-induced tissue injury and chemotactic stimuli have been proposed as potential causes of BCS lesion formation. BCS has been suggested to be a variant of multiple sclerosis (MS). Here, we aimed to elucidate similarities and differences between BCS and MS by describing lesion morphology and localization in high-resolution 7 Tesla (7 T) magnetic resonance imaging (MRI) scans. METHODS: Ten patients with Baló-type lesions underwent 7 T MRI, and 10 relapsing remitting MS patients served as controls. The 7 T MR imaging protocol included 3D T(1)-weighted (T(1)w) magnetization-prepared rapid gradient echo, 2D high spatial resolution T(2)*-weighted (T(2)*w) fast low-angle shot and susceptibility-weighted imaging. RESULTS: Intralesional veins were visible in the center of all but one Baló-type lesion. Four Baló-type lesions displayed inhomogeneous intralesional T(2)*w signal intensities, which are suggestive of microhemorrhages or small ectatic venules. Eight of 10 BCS patients presented with 97 additional lesions, 36 of which (37%) had a central vein. Lesions involving the cortical gray matter and the U-fibers were not detected in BCS patients. CONCLUSION: Our findings support the hypothesis that BCS and MS share common pathogenetic mechanisms but patients present with different lesion phenotypes.