Initial investigation of the blood-brain barrier in MS lesions at 7 tesla

Mult Scler. 2013 Jul;19(8):1068-73. doi: 10.1177/1352458512471093. Epub 2012 Dec 17.


Background: We previously described two dynamics of contrast enhancement in scans of active multiple sclerosis lesions: Medium-sized, early lesions enhance centrifugally, whereas larger, slightly older lesions enhance centripetally. Due to technical limitations, our previous study did not characterize lesions < 5 mm in diameter, cortical enhancement, and anatomical structures within lesions.

Objective: The objective of this paper is to obtain initial observations of these important aspects of lesion development on a 7 tesla scanner at high spatial resolution.

Methods: We scanned eight patients, acquiring precontrast T2*-weighted scans, T1-weighted scans before and after contrast, and high-resolution dynamic contrast-enhanced scans during and up to 30 min after contrast.

Results: We detected 15 enhancing lesions, obtaining dynamic data in 10: Five lesions < 4 mm enhanced centrifugally (initial central enhancement expanded outward), and five lesions > 4 mm enhanced centripetally (initial peripheral enhancement gradually filled the lesion). A leukocortical lesion initially showed enhancement in its white matter portion, which gradually spread into the cortex. Seventy-three percent of lesions were clearly perivenular.

Conclusion: Most active lesions are perivenular, and the smallest lesions enhance centrifugally. This supports the idea that lesions grow outward from a central vein.

Keywords: 7 tesla; Veins; blood-brain barrier; contrast-enhancing lesions; magnetic resonance imaging; susceptibility weighted imaging.

Publication types

  • Research Support, N.I.H., Intramural

MeSH terms

  • Adult
  • Blood-Brain Barrier / pathology*
  • Brain / pathology
  • Disease Progression
  • Female
  • Humans
  • Image Enhancement
  • Image Interpretation, Computer-Assisted
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Multiple Sclerosis / pathology*