MR imaging detects possible new biomarker for multiple sclerosis

Approximately 400,000 people in the US have multiple sclerosis, a debilitating disease that affects the central nervous system. Lesions slow or block the nerve signals that control muscle coordination and strength, along with sensation and vision. Now, using T1-weighted magnetic resonance (MR) imaging, researchers may have discovered a good biomarker for the disease’s progression.

As reported in the September issue of Radiology, Dr. Rohit Bakshi from Brigham and Women’s Hospital and Harvard Medical School in Boston and his colleagues analyzed the frequency and physical features of hyperintense (bright) lesions on nonenhanced T1-weighted MR images from patients with multiple sclerosis. They wanted to see whether there was a relationship between the lesions and physical disability, disease progression and certain kinds of tissue damage, such as brain atrophy.

The researchers analyzed MR imaging data from 145 multiple sclerosis patients for location, size and morphology of the lesions. Both T1- and T2-weighted images were acquired at 1.5 T using either a Signa 4X/LX made by GE Healthcare of Milwaukee or an ACS NT Gyroscan made by Philips Medical Systems of Best, the Netherlands.

They found at least one T1 hyperintense lesion in 113 of the patients, with a total of 340 lesions discovered; the total number did not have a significant association with age, gender or disease duration. However, the number did correlate significantly with physical disability (as did the number of T1 hypointense, or dark, lesions), whereas the number of T2 hyperintense lesions did not (using the Spearman rank correlation test). The number of T1 hyperintense lesions also was associated with the disease’s progression (using the Fisher exact probability test), whereas the number of T2 hyperintense lesions and the number of T1 hypointense lesions were not. The number of T1 hyperintense lesions also was associated significantly with MR measures of brain atrophy.

The researchers believe that their results suggest that T1 hyperintense lesions are common in patients with multiple sclerosis and, furthermore, are associated with brain atrophy, disability and the disease’s advancing course. In conclusion, the hyperintense lesions might be good biomarkers for the disease process.