Title :

Punctate pattern: A promising imaging marker for the diagnosis of natalizumab-associated PML

Author(s) :

Hodel, Jerome [Auteur]
Darchis, Christine [Auteur]
Outteryck, Olivier [Auteur]
Lille Inflammation Research International Center (LIRIC) - U995
Lille Inflammation Research International Center (LIRIC) - U995
Verclytte, Sebastien [Auteur]
Deramecourt, Vincent [Auteur]
Lille Neurosciences & Cognition (LilNCog) - U 1172
Lacour, Arnaud [Auteur]
Zins, Marc [Auteur]
Pruvo, Jean-Pierre [Auteur]
Troubles cognitifs dégénératifs et vasculaires - U1171
Troubles cognitifs dégénératifs et vasculaires - U1171
Vermersch, Patrick [Auteur]
Lille Inflammation Research International Center (LIRIC) - U995
Lille Inflammation Research International Center (LIRIC) - U995
Leclerc, Xavier [Auteur]
Troubles cognitifs dégénératifs et vasculaires - U1171
Troubles cognitifs dégénératifs et vasculaires - U1171

Journal title :

Neurology

Abbreviated title :

Neurology

Volume number :

86

Pages :

1516-1523

Publication date :

2016-04-19

ISSN :

0028-3878
1526-632X

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

OBJECTIVE: To evaluate the usefulness of the punctate pattern (PP) for the diagnosis and follow-up of patients with progressive multifocal leukoencephalopathy (PML). METHODS: A cohort of 20 consecutive patients with PML, ...
Show more >OBJECTIVE: To evaluate the usefulness of the punctate pattern (PP) for the diagnosis and follow-up of patients with progressive multifocal leukoencephalopathy (PML). METHODS: A cohort of 20 consecutive patients with PML, related to natalizumab (NTZ) (n = 14) or not (n = 6), underwent 3T MRI (147 MRI examinations). MRI was available at presymptomatic (n = 9 patients), symptomatic (n = 15), immune reconstitution inflammatory syndrome (IRIS), and chronic stages (n = 20). A pathologic control group of patients without PML (n = 80), with clinically definitive multiple sclerosis or a clinically isolated syndrome suggestive of CNS demyelination, underwent the same MRI protocol. Number and appearance of punctate lesions were assessed by 3 blinded readers using T2-weighted, fluid-attenuated inversion recovery (FLAIR), and postcontrast T1-weighted images. RESULTS: Interobserver agreement was good (κ = 0.79) (0.72-0.87). Of the 20 patients with PML, 18 had PP, including the 14 patients with NTZ-PML; none in the pathologic control group. Of the 9 presymptomatic patients with NTZ-PML, PP was observed in 7 (78% sensitive and 100% specific). Nonenhancing PP on T2-weighted/FLAIR images was detected in 13 patients with PML, exclusively at the presymptomatic or symptomatic stages (including 7 NTZ-PML), whereas enhancing PP occurred in 16 patients with PML, including 13 of the 14 patients with NTZ-PML at the IRIS stage. CONCLUSIONS: PP is a highly specific feature of PML and may be the first imaging feature at the presymptomatic stage with potential implications in patient care. METHODS: This study provides Class II evidence that a PP on MRI accurately identifies patients with NTZ-PML.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Inserm
Université de Lille
CHU Lille
CNRS

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
• Lille Neurosciences & Cognition (LilNCog) - U 1172
• Troubles cognitifs dégénératifs et vasculaires - U1171

Research team(s) :

Immunity, inflammation and fibrsis in auto and allo-reactivity

Submission date :

2019-03-01T14:19:51Z