Details

Autor(en) / Beteiligte

• Wattjes, Mike P
• Vennegoor, Anke
• Steenwijk, Martijn D
• de Vos, Marlieke
• Killestein, Joep
• van Oosten, Bob W
• Mostert, Jop
• Siepman, Dorine A
• Moll, Wiebe
• van Golde, Alex E L
• Frequin, Stephan T F M
• Richert, Nancy D
• Barkhof, Frederik

Titel

MRI pattern in asymptomatic natalizumab-associated PML

Ist Teil von

• Journal of neurology, neurosurgery and psychiatry, 2015-07, Vol.86 (7), p.793-798

Ort / Verlag

England: BMJ Publishing Group LTD

Erscheinungsjahr

2015

Link zum Volltext

Quelle

BMJ Journals Archiv - DFG Nationallizenzen

Beschreibungen/Notizen

• ObjectiveTo investigate the MRI manifestation pattern of asymptomatic natalizumab-associated progressive multifocal leukoencephalopathy (PML) in patients with multiple sclerosis (MS).Methods18 patients with MS with natalizumab-associated PML lesions on MRI were included. In 6 patients, the PML lesions were identified on MRI prospectively and in 12 patients PML lesions were identified retrospectively. MRI sequences were analysed for PML lesion distribution, appearance, grey matter/white matter involvement and possible signs of inflammation. Lesion probability maps were created to demonstrate lesion distribution pattern.ResultsThe frontal lobe was involved in 14 patients (77.8%) and the parietal lobe in 4 patients (22.2%). Most patients presented with focal lesions (13 patients, 72.2%) involving one single lobe (12 patients, 66.7%). The cortical grey matter was affected in 15 patients (83.3%) and 13 patients (72.2%) presented with a combination of cortical grey and white matter involvement. Signs of inflammation were detected in 7 patients (38.8%). Among patients with available diffusion-weighted imaging, 6 patients (40%) did not show high-signal-intensity lesions. A classical imaging pattern including unilateral and unilobar focal lesions in the frontal lobe affecting the cortical grey matter or the cortical grey and adjacent white matter was observed in 8 patients (44.4%).ConclusionsAsymptomatic natalizumab-associated PML manifestations on MRI show a rather localised disease, frequently located in the frontal lobes, affecting the cortical grey matter and adjacent juxtacortical white matter. Awareness of this lesion pattern facilitates an earlier diagnosis of natalizumab-associated PML in an asymptomatic stage associated with a more favourable prognosis.