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Open Access 01-12-2021 | Multiple Sclerosis | Original Article

The brainstem in multiple sclerosis: MR identification of tracts and nuclei damage

Authors: Thien Huong Nguyen, Alexis Vaussy, Violette Le Gaudu, Jennifer Aboab, Sophie Espinoza, Irina Curajos, Emmanuel Heron, Christophe Habas

Published in: Insights into Imaging | Issue 1/2021

Abstract

Objective

To evaluate the 3D Fast Gray Acquisition T1 Inversion Recovery (FGATIR) sequence for MRI identification of brainstem tracts and nuclei damage in multiple sclerosis (MS) patients.

Methods

From april to december 2020, 10 healthy volunteers and 50 patients with remitted-relapsing MS (58% female, mean age 36) underwent MR imaging in the Neuro-imaging department of the C.H.N.O. des Quinze-Vingts, Paris, France. MRI was achieved on a 3 T system (MAGNETOM Skyra) using a 64-channel coil. 3D FGATIR sequence was first performed on healthy volunteers to classify macroscopically identifiable brainstem structures. Then, FGATIR was assessed in MS patients to locate brainstem lesions detected with Proton Density/T2w (PD/T2w) sequence.

Results

In healthy volunteers, FGATIR allowed a precise visualization of tracts and nuclei according to their myelin density. Including FGATIR in MR follow-up of MS patients helped to identify structures frequently involved in the inflammatory process. Most damaged tracts were the superior cerebellar peduncle and the transverse fibers of the pons. Most frequently affected nuclei were the vestibular nuclei, the trigeminal tract, the facial nerve and the solitary tract.

Conclusion

Combination of FGATIR and PD/T2w sequences opened prospects to define MS elective injury in brainstem tracts and nuclei, with particular lesion features suggesting variations of the inflammatory process within brainstem structures. In a further study, hypersignal quantification and microstructure information should be evaluated using relaxometry and diffusion tractography. Technical improvements would bring novel parameters to train an artificial neural network for accurate automated labeling of MS lesions within the brainstem.

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Title: The brainstem in multiple sclerosis: MR identification of tracts and nuclei damage
Authors: Thien Huong Nguyen
Alexis Vaussy
Violette Le Gaudu
Jennifer Aboab
Sophie Espinoza
Irina Curajos
Emmanuel Heron
Christophe Habas
Publication date: 01-12-2021
Publisher: Springer International Publishing
Keyword: Multiple Sclerosis
Published in: Insights into Imaging / Issue 1/2021
Electronic ISSN: 1869-4101
DOI: https://doi.org/10.1186/s13244-021-01101-7

At a glance: The STEP trials

Springer Medicine

The brainstem in multiple sclerosis: MR identification of tracts and nuclei damage

Abstract

Objective

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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