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Punctate pattern: A promising imaging ...
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Document type :
Article dans une revue scientifique
DOI :
10.1212/WNL.0000000000002586
PMID :
27009257
Permalink :
http://hdl.handle.net/20.500.12210/4812
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] refId
Lille Inflammation Research International Center (LIRIC) - U995
Lille Inflammation Research International Center (LIRIC) - U995
Verclytte, Sebastien [Auteur]
Deramecourt, Vincent [Auteur] refId
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] refId
Lille Inflammation Research International Center (LIRIC) - U995
Lille Inflammation Research International Center (LIRIC) - U995
Leclerc, Xavier [Auteur] refId
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, ...
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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
Université de Lille

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