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Abstract #4343

Diagnose acute gadolinium enhancing multiple sclerosis lesions using gradient echo MRI (R2* and QSM) without gadolinium injection

Lijie Tu 1,2 , Yan Zhang 1,3 , Ajay Gupta 1 , Joseph Comunale 1 , Thanh Nguyen 1 , Susan Gauthier 4 , and Yi Wang 1,5

1 Radiology, Weill Cornell Medical College, New York, NY, United States, 2 Applied & Engineering Physics, Cornell University, Ithaca, NY, United States, 3 Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technoology, Wuhan, Hubei, China, 4 Neurology, Weill Cornell Medical College, New York, NY, United States, 5 Biomedical Engineering, Cornell University, Ithaca, NY, United States

During an multiple sclerosis (MS) lesion formation, first there is acute blood-brain-barrier breakdown (gadolilnium (Gd) enhancing) and demyelination, reducing subvoxel structure heterogeneity or R2*. Then there is subacute clearance of myelin debris by microglia/macrophages (m/M) and further inflammation by m/M laden with iron, increasing susceptibility as measured on QSM. We found most Gd-enhancing lesions are R2* hypointense and QSM isointense. Without using Gd injection, the sensitivity to identify Gd-enhancing lesions as isointense on QSM, is 89%, and the specificity is 97%.

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