Evolution of the blood-brain barrier in newly forming multiple sclerosis lesions.
Evolution of the blood-brain barrier in newly forming multiple sclerosis lesions.
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DOI：
10.1002/ana.22472
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发表时间：
2011-07
影响因子：
11.2
通讯作者：
Reich, Daniel S.
中科院分区：
文献类型：
--
作者：
Gaitan, Maria I.;Shea, Colin D.;Evangelou, Iordanis E.;Stone, Roger D.;Fenton, Kaylan M.;Bielekova, Bibiana;Massacesi, Luca;Reich, Daniel S.
多发性硬化（MS）病变发生在小的、发炎的静脉周围。磁共振成像（MRI）上钆增强的新病变反映了血脑屏障（BBB）的破坏。病理学和标准MRI的单个时间点结果无法捕获病变的时空扩展。我们研究了新的MS病变的发展和扩大，重点是BBB通透性的动态。我们在复发缓解型MS中进行了动态对比增强（DCE）MRI。我们在注射钆期间和之后获得了超过65分钟的数据。我们标记的时空增强动力学为离心时，最初的中央增强向外扩展和向心时，最初的周边增强逐渐填补中心。我们在200次DCE-MRI扫描中发现了34个增强病灶。在65%的患者中，增强首先表现为闭合环，18%表现为结节，18%表现为开放环。结节状强化的病灶比环形强化的病灶小（p<0.0001）。所有最初的结节状病变均呈离心性增强，而最初的环形病变呈向心性增强，如果较小则变为结节状（82%），如果较大则接近结节状（18%）。开放环病变位于脑室周围或脑室皮质，向心性增强。血管性增强病变在几天内演变为向心性增强病变。增强动力学从离心到向心的快速变化反映了MS病变围绕其中心静脉的向外生长，并表明介导病变生长和组织修复的因素来自不同时间的不同位置。我们提出了一个新的病灶生长模型，将我们的成像观察与现有的病理学数据相结合。
Multiple-sclerosis (MS) lesions develop around small, inflamed veins. New lesions enhance with gadolinium on magnetic resonance imaging (MRI), reflecting disruption of the blood-brain barrier (BBB). Single time point results from pathology and standard MRI cannot capture the spatiotemporal expansion of lesions. We investigated the development and expansion of new MS lesions, focusing on the dynamics of BBB permeability. We performed dynamic-contrast-enhanced (DCE) MRI in relapsing-remitting MS. We obtained data over 65 minutes, during and after gadolinium injection. We labeled spatiotemporal enhancement dynamics as centrifugal when initially central enhancement expanded outward and centripetal when initially peripheral enhancement gradually filled the center. We detected thirty-four enhancing lesions in 200 DCE-MRI scans. In 65%, enhancement first appeared as a closed ring; in 18%, as a nodule; and in 18%, as an open ring. Lesions with initially nodular enhancement were smaller than those initially enhancing as rings (p<0.0001). All initially nodular lesions enhanced centrifugally, whereas initially ringlike lesions enhanced centripetally, becoming nodular if small (82%) or nearly nodular if larger (18%). Open-ring lesions were periventricular or juxtacortical and enhanced centripetally. Centrifugally enhancing lesions evolved into centripetally enhancing lesions over several days. The rapid change of enhancement dynamics from centrifugal to centripetal reflects the outward growth of MS lesions around their central vein and suggests that factors mediating lesion growth and tissue repair derive from different locations at different times. We propose a model of new lesion growth that unites our imaging observations with existing pathology data.
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影响因子：
2.3
作者：
Lacerda, Saulo;Law, Meng
通讯作者：
Law, Meng
影响因子：
11.2
作者：
Filippi, M;Rocca, MA;Comi, G
通讯作者：
Comi, G
影响因子：
3.3
作者：
Luedemann, Lutz;Warmuth, Carsten;Amthauer, Holger
通讯作者：
Amthauer, Holger
影响因子：
4.8
作者：
Bagheri, Mohammad Hadi;Meshksar, Arash;Nikseresht, Alireza R.
通讯作者：
Nikseresht, Alireza R.
DOI：
10.1097/01.jnen.0000235119.52311.16
发表时间：
2006-09-01
影响因子：
3.2
作者：
Hochmeister, Sonja;Grundtner, Roland;Lassmann, Hans
通讯作者：
Lassmann, Hans