Hodel J, Outteryck O, Verclytte S, Deramecourt V, Lacour A, Pruvo J-P, Vermersch P, Leclerc X
From the University of Lille, CHU Lille (J.H., O.O., V.D., A.L., J.-P.P., P.V., X.L.), Lille, France Departments of Neuroradiology (J.H., J.-P.P., X.L.)
From the University of Lille, CHU Lille (J.H., O.O., V.D., A.L., J.-P.P., P.V., X.L.), Lille, France Neurology (O.O., A.L., P.V.), Roger Salengro Hospital, Lille, France.
AJNR Am J Neuroradiol. 2015 Dec;36(12):2296-302. doi: 10.3174/ajnr.A4436. Epub 2015 Aug 27.
We investigated the brain magnetic susceptibility changes induced by natalizumab-associated progressive multifocal leukoencephalopathy. We retrospectively included 12 patients with natalizumab-progressive multifocal leukoencephalopathy, 5 with progressive multifocal leukoencephalopathy from other causes, and 55 patients with MS without progressive multifocal leukoencephalopathy for comparison. MR imaging examinations included T2* or SWI sequences in patients with progressive multifocal leukoencephalopathy (86 examinations) and SWI in all patients with MS without progressive multifocal leukoencephalopathy. Signal abnormalities on T2* and SWI were defined as low signal intensity within the cortex and/or U-fibers and the basal ganglia. We observed T2* or SWI signal abnormalities at the chronic stage in all patients with progressive multifocal leukoencephalopathy, whereas no area of low SWI signal intensity was detected in patients without progressive multifocal leukoencephalopathy. Among the 8 patients with asymptomatic natalizumab-progressive multifocal leukoencephalopathy, susceptibility changes were observed in 6 (75%). The basal ganglia adjacent to progressive multifocal leukoencephalopathy lesions systematically appeared hypointense by using T2* and/or SWI. Brain magnetic susceptibility changes may be explained by the increased iron deposition and constitute a useful tool for the diagnosis of progressive multifocal leukoencephalopathy.
我们研究了那他珠单抗相关的进行性多灶性白质脑病引起的脑磁敏感性变化。我们回顾性纳入了12例那他珠单抗相关的进行性多灶性白质脑病患者、5例其他原因导致的进行性多灶性白质脑病患者以及55例无进行性多灶性白质脑病的多发性硬化症患者作为对照。磁共振成像检查包括对进行性多灶性白质脑病患者进行的T2或磁敏感加权成像（SWI）序列检查（86次检查），以及对所有无进行性多灶性白质脑病的多发性硬化症患者进行的SWI检查。T2和SWI上的信号异常定义为皮质和/或U形纤维以及基底神经节内的低信号强度。我们在所有进行性多灶性白质脑病患者的慢性期观察到T2或SWI信号异常，而在无进行性多灶性白质脑病的患者中未检测到SWI低信号强度区域。在8例无症状的那他珠单抗相关的进行性多灶性白质脑病患者中，6例（75%）观察到了磁敏感性变化。通过T2和/或SWI，与进行性多灶性白质脑病病变相邻的基底神经节系统性地呈现为低信号。脑磁敏感性变化可能由铁沉积增加所解释，并构成诊断进行性多灶性白质脑病的有用工具。
