Department of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
Mult Scler Relat Disord. 2016 May;7:61-4. doi: 10.1016/j.msard.2016.03.010. Epub 2016 Mar 21.
In multiple sclerosis (MS) lesions blood-brain-barrier (BBB) breakdown is a common phenomenon delineating the phase of focal inflammation in developing MS lesions. In other pathologies like cerebral amyloid angiopathy or arteriosclerotic cerebral small vessel disease permanent cerebral microbleeds (CMB) have been shown to be sensitive markers indicating BBB dysfunction. We were interested in the potential role of T(2)*-weighted MRI and CMBs as BBB integrity markers in MS.
A large cohort of 189 MS patients (179 relapsing remitting MS and 10 secondary progressive MS) was investigated on a 3T MRI system with conventional and T(2)*-weighted gradient echo MRI (T(2)*w) sequences. T(2)*w images were analysed for CMBs by experienced raters.
None of the MS patients showed a CMB.
On T(2)*w MRI the prevalence of CMBs is not higher in MS patients than what is to be expected in young healthy people. In contrast to pathologies with structural vascular changes like small vessel disease or cerebral amyloid angiopathy, CMBs are not seen in MS where the immune reaction is causing a functional change in the BBB.
在多发性硬化症（MS）病变中，血脑屏障（BBB）破坏是一个常见现象，表明正在形成的 MS 病变中存在局灶性炎症阶段。在其他病理学中，如脑淀粉样血管病或动脉粥样硬化性小血管疾病，永久性脑微出血（CMB）已被证明是敏感的 BBB 功能障碍标志物。我们对 T（2）*加权 MRI 和 CMB 作为 MS 中 BBB 完整性标志物的潜在作用感兴趣。
在 3T MRI 系统上对 189 例 MS 患者（179 例复发缓解型 MS 和 10 例继发进展型 MS）进行了研究，采用常规和 T（2）*加权梯度回波 MRI（T（2）*w）序列。经验丰富的评估者对 T（2）*w 图像进行 CMB 分析。
没有 MS 患者出现 CMB。
在 T（2）*w MRI 上，MS 患者的 CMB 患病率并不高于年轻健康人群。与结构血管变化相关的病理学不同，如小血管疾病或脑淀粉样血管病，在导致 BBB 功能改变的免疫反应中，MS 中不会出现 CMB。
