Multiparametric Characterization and Spatial Distribution of Different MS Lesion Phenotypes

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FIG 1.
Flow chart of the MS lesions evaluation based on QSM and SMWI visualization.
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FIG 2.
Examples of different MS lesion phenotypes. A, B, and C, MS lesions (black arrow) on FLAIR (upper image) and on QSM (lower image) classified, respectively, in HYPER, ISO-HYPO, and PRLs groups. D and E, MS lesions (white arrows) on FLAIR (left), QSM (center), and SMWI (right), which were relocated, respectively, from PRLs to HYPER and from HYPER to ISO-HYPO groups; particularly in D, the hyperintense rim on QSM was determined to be composed of 2 veins (visible as hypointense signal in SMWI). E, The hyperintensity on QSM located at the center of the lesion was a central vein, as shown on SMWI.
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FIG 3.
Quantitative MR imaging metrics of myelin and axonal loss in different MS lesion phenotypes. Comparisons were performed using ANOVA with Bonferroni post hoc comparisons, controlling for age, sex, lesion volume, and subject identification as confounding factors. T1-relaxation times are expressed in milliseconds. **P ≤ .05; ****P < .001.

Table 1:

Demographic and clinical features

Note:—RRMS indicates relapsing-remitting MS; NA, not applicable; DMT, disease-modifying therapy.

Table 2:

Comparison of lesion volume and quantitative MR imaging values of the 3 lesion phenotypes

	ISO-HYPO (Mean) (SD)	HYPER (Mean) (SD)	PRL (Mean) (SD)	ISO-HYPO vs HYPER (P Value)	ISO-HYPO vs PRL (P Value)	HYPER vs PRL (P Value)
Lesion volume (μL)	311.44 (1069.32)	820.93 (1733.99)	955.35 (891.77)	<.001^{^a}	<.001^{^a}	.455
ICVF	0.47 (0.09)	0.42 (0.08)	0.41 (0.08)	<.001^{^a}	<.001^{^a}	.188
ODI	0.23 (0.07)	0.21 (0.06)	0.22 (0.05)	.060	.506	.703
FWF	0.03 (0.03)	0.04 (0.05)	0.07 (0.07)	.006^{^a}	<.001^{^a}	<.001^{^a}
MWF	0.075 (0.035)	0.068 (0.031)	0.062 (0.030)	.016^{^a}	.022^{^a}	.336
T1-relaxometry (ms)	1027.05 (131.35)	1077.18 (157.63)	1181.43 (157.01)	.001^{^a}	<.001^{^a}	<.001^{^a}
QSM values (ppb)	–9.10 (23.7)	9.06 (25.1)	7.75 (23.5)	<.001^{^a}	<.001^{^a}	.567
Distance from ventricular CSF (mm)	14.6 (9.8)	12.5 (9.7)	10.5 (7.4)	.059	.018^{^a}	.177

Table 3:

Pearson correlation among age, EDSS, and ARMSS with the volume of the different MS lesion phenotypes

	ISO-HYPO		HYPER		PRL		HYPER + PRL
	r	P Value	r	P Value	r	P Value	r	P Value
Age	0.045	.763	−0.060	.689	−0.015	.920	−0.082	.583
EDSS	−0.180	.232	0.282	.057	−0.160	.289	0.228	.127
ARMSS	−0.268	.079	0.382	.011^a	−0.167	.277	0.342	.023^a