Department of Neurology (T.S., J.O., M.K., I.S., A.K., P.W., P.K., J.F.), Asklepios Fachklinikum Teupitz; NeuroCure Clinical Research Center (T.S., F.P., J.W.), Experimental and Clinical Research Center (T.N., F.P.), Department of Neurology (F.P.), and Clinical and Experimental Multiple Sclerosis Research Center (F.P.), Charité-Universitätsmedizin Berlin; Medical Physics (R.M.), Physikalisch-Technische Bundesanstalt; Berlin Ultrahigh Field Facility (T.N., J.W.) and Experimental and Clinical Research Center (T.N., F.P.), Max Delbrück Center for Molecular Medicine, Berlin; Institute of Neuroradiology (J.W.), Universitätsmedizin Göttingen, Germany; and MIAC AG (J.W.), Basel, Switzerland.
Neurol Neuroimmunol Neuroinflamm. 2015 Oct 29;2(6):e171. doi: 10.1212/NXI.0000000000000171. eCollection 2015 Dec.
To assess the ability of ultra-high-field MRI to distinguish early progressive multifocal leukoencephalopathy (PML) from multiple sclerosis (MS) lesions in a rare case of simultaneous presentation of natalizumab-associated PML and ongoing MS activity.
Advanced neuroimaging including 1.5T, 3T, and 7T MRI with a spatial resolution of up to 0.08 mm(3) was performed.
7T MRI differentiated between PML-related and MS-related brain damage in vivo. Ring-enhancing MS plaques displayed a central vein, whereas confluent PML lesions were preceded by punctate or milky way-like T2 lesions.
Given the importance of early diagnosis of treatment-associated PML, future systematic studies are warranted to assess the value of highly resolving MRI in differentiating between early PML- and MS-induced brain parenchymal lesions.
评估超高场 MRI 区分同时出现的那他珠单抗相关性进行性多灶性白质脑病（PML）和活动期多发性硬化（MS）病变的能力，该罕见病例同时存在这两种疾病。
进行了包括 1.5T、3T 和 7T MRI 在内的高级神经影像学检查，空间分辨率高达 0.08mm³。
7T MRI 可在体内区分 PML 相关性和 MS 相关性脑损伤。环形增强的 MS 斑块显示中央静脉，而融合性 PML 病变之前存在点状或银河样 T2 病变。
鉴于早期诊断治疗相关性 PML 的重要性，未来有必要进行系统研究来评估高分辨率 MRI 在区分早期 PML 和 MS 引起的脑实质病变方面的价值。
