Paramagnetic Rim Lesions are Specific to Multiple Sclerosis: An International Multicenter 3T MRI Study
Pietro Maggi, Pascal Sati, Govind Nair, Irene Cortese, Steven Jacobson, Bryan Smith, Avindra Nath, Joan Ohayon, Vincent Van Pesch, Gaetano Perrotta, Caroline Pot, Marie Théaudin, Vittorio Martinelli, Roberta Scotti, Tianxia Wu, Renaud Du Pasquier, Peter A. Calabresi, Massimo Filippi, Daniel H. Reich, Martina Absinta
Abstract
In multiple sclerosis (MS), a subset of chronic active white matter lesions are identifiable on magnetic resonance imaging by their paramagnetic rims, and increasing evidence supports their association with severity of clinical disease. We studied their potential role in differential diagnosis, screening an international multicenter clinical research-based sample of 438 individuals affected by different neurological conditions (MS, other inflammatory, infectious, and non-inflammatory conditions). Paramagnetic rim lesions, rare in other neurological conditions (52% of MS vs 7% of non-MS cases), yielded high specificity (93%) in differentiating MS from non-MS. Future prospective multicenter studies should validate their role as a diagnostic biomarker. ANN NEUROL 2020;88:1034-1042.