ArticlePloS one2015
T1- Thresholds in Black Holes Increase Clinical-Radiological Correlation in Multiple Sclerosis Patients.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
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Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Disease-modifying therapies and T1 hypointense lesions in patients with multiple sclerosis: A systematic review and meta-analysis.CNS neuroscience & therapeutics · 2022Pooled it
- Correlation between the clinical disability and T1 hypointense lesions' volume in cerebral magnetic resonance imaging of multiple sclerosis patients: A systematic review and meta-analysis.CNS neuroscience & therapeutics · 2021Pooled it
- Silent cerebral infarct definitions and full-scale IQ loss in children with sickle cell anemia.Neurology · 2018Trial
- Instance-level quantitative saliency in multiple sclerosis lesion segmentation.Scientific reports · 2026Article
- Article
- Transforming grayscale MRI images to color utilizing generative artificial intelligence to better understand multiple sclerosis.Journal of central nervous system disease · 2025Article
- Clinical relevance of paramagnetic rim lesion heterogeneity in multiple sclerosis.Annals of clinical and translational neurology · 2024Article
- Quantitative TEuropean radiology · 2024Article
- Evaluation of the Blood-Brain Barrier, Demyelination, and Neurodegeneration in Paramagnetic Rim Lesions in Multiple Sclerosis on 7 Tesla MRI.Journal of magnetic resonance imaging : JMRI · 2024Article
- Tract-wise microstructural analysis informs on current and future disability in early multiple sclerosis.Journal of neurology · 2024Article
- Inhomogeneous magnetization transfer (ihMT) imaging reveals variable recovery profiles of active MS lesions according to size and localization.Imaging neuroscience (Cambridge, Mass.) · 2024Article
- Pediatric Onset Multiple Sclerosis and Obesity: Defining the Silhouette of Disease Features in Overweight Patients.Nutrients · 2023Article
- Magnetic Resonance Imaging in Primary Progressive Multiple Sclerosis Patients : Review.Clinical neuroradiology · 2022Review
- Periventricular gradient of TNeuroImage. Clinical · 2022Article
- The Application of Diffusion Kurtosis Imaging on the Heterogeneous White Matter in Relapsing-Remitting Multiple Sclerosis.Frontiers in neuroscience · 2022Article
- 7T MRI Differentiates Remyelinated from Demyelinated Multiple Sclerosis Lesions.Annals of neurology · 2021Article
- Cortical diffusion kurtosis imaging and thalamic volume are associated with cognitive and walking performance in relapsing-remitting multiple sclerosis.Journal of neurology · 2021Article
- Quantitative magnetic resonance imaging towards clinical application in multiple sclerosis.Brain : a journal of neurology · 2021Review
- Diagnosis of Progressive Multiple Sclerosis From the Imaging Perspective: A Review.JAMA neurology · 2021Review
- Article
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9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMagnetic Resonance Imaging (MRI) is an established tool in diagnosing and evaluating disease activity in Multiple Sclerosis (MS). While clinical-radiological correlations are limited in general, hypointense T1 lesions (also known as Black Holes (BH)) have shown some promising results. The definition of BHs is very heterogeneous and depends on subjective visual evaluation.
objectiveWe aimed to improve clinical-radiological correlations by defining BHs using T1 relaxation time (T1-RT) thresholds to achieve best possible correlation between BH lesion volume and clinical disability.
method40 patients with mainly relapsing-remitting MS underwent MRI including 3-dimensional fluid attenuated inversion recovery (FLAIR), magnetization-prepared rapid gradient echo (MPRAGE) before and after Gadolinium (GD) injection and double inversion-contrast magnetization-prepared rapid gradient echo (MP2RAGE) sequences. BHs (BHvis) were marked by two raters on native T1-weighted (T1w)-MPRAGE, contrast-enhancing lesions (CE lesions) on T1w-MPRAGE after GD and FLAIR lesions (total-FLAIR lesions) were detected separately. BHvis and total-FLAIR lesion maps were registered to MP2RAGE images, and the mean T1-RT were calculated for all lesion ROIs. Mean T1 values of the cortex (CTX) were calculated for each patient. Subsequently, Spearman rank correlations between clinical scores (Expanded Disability Status Scale and Multiple Sclerosis Functional Composite) and lesion volume were determined for different T1-RT thresholds.
resultsSignificant differences in T1-RT were obtained between all different lesion types with highest T1 values in visually marked BHs (BHvis: 1453.3±213.4 ms, total-FLAIR lesions: 1394.33±187.38 ms, CTX: 1305.6±35.8 ms; p<0.05). Significant correlations between BHvis/total-FLAIR lesion volume and clinical disability were obtained for a wide range of T1-RT thresholds. The highest correlation for BHvis and total-FLAIR lesion masks were found at T1-RT>1500 ms (Expanded Disability Status Scale vs. lesion volume: rBHvis = 0.442 and rtotal-FLAIR = 0.497, p<0.05; Multiple Sclerosis Functional Composite vs. lesion volume: rBHvis = -0.53 and rtotal-FLAIR = -0.627, p<0.05).
conclusionClinical-radiological correlations in MS patients are increased by application of T1-RT thresholds. With the short acquisition time of the MP2RAGE sequences, quantitative T1 maps could be easily established in clinical studies.
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