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Multiple sclerosis and cerebral endothelial dysfunction: Mechanisms

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1 Multiple sclerosis and cerebral endothelial dysfunction: Mechanisms
J. Steven Alexander, Robert Zivadinov, Amir-Hadi Maghzi, Vijay C. Ganta, Meghan K. Harris, Alireza Minagar  Pathophysiology  Volume 18, Issue 1, Pages 3-12 (February 2011) DOI: /j.pathophys Copyright © 2010 Elsevier Ireland Ltd Terms and Conditions

2 Fig. 1 Representative axial FLAIR image shows widespread white matter lesions in the periventricular region (a). Supratentorial periventricular lesions are especially well visualized by FLAIR imaging compared to T2-WI where cerebrospinal fluid may mask the visualization of these lesions (a). White matter lesions may also be seen at the cortical level (b). Three different types of cortical lesions are found in patients with MS: (1) juxtacortical lesions (Type 1) (b), located on the border between GM and WM; (2) intracortical lesions (Type 2) (b); and (3) subpial cortical lesions (Type 3), a class of GM lesion recently identified using new myelin basic protein-based pathologic staining methods. Pathophysiology  , 3-12DOI: ( /j.pathophys ) Copyright © 2010 Elsevier Ireland Ltd Terms and Conditions

3 Fig. 2 Enhancing lesions typical of MS on axial T1-WI post-contrast scans after gadolinium injection (0.1mmol/kg). Two types of enhancing lesions are present in a 35-year-old female with RRMS with significant residual deficit and disability: homogenous lesions (hyperintense on T1-WI) and open-ring lesions (with central hypointense and external hyperintense rim). Pathophysiology  , 3-12DOI: ( /j.pathophys ) Copyright © 2010 Elsevier Ireland Ltd Terms and Conditions

4 Fig. 3 Axial T1-WI in a 43-year-old female with RRMS and EDSS score of 5.5. On T1-WI, multiple lesions are hypointense or appear as “black holes”. Pathophysiology  , 3-12DOI: ( /j.pathophys ) Copyright © 2010 Elsevier Ireland Ltd Terms and Conditions

5 Fig. 4 Evaluation of T2 hyperintense lesions in patients with RRMS on FLAIR images. 1.5T scanner (a) shows less T2 lesions than 3T (b) (arrows). Pathophysiology  , 3-12DOI: ( /j.pathophys ) Copyright © 2010 Elsevier Ireland Ltd Terms and Conditions


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